Partial Nephrectomy Prolongs Survival in Younger Patients
ORLANDO, Fla.—Partial nephrectomy (PN) for small localized renal cell carcinoma tumors provides a long-term survival advantage over radical nephrectomy (RN) among younger patients, according to data presented at the annual Genitourinary Cancers Symposium.
In a study of patients aged 20-44 years with localized tumors smaller than 4 cm, researchers found no significant difference in five-year overall survival between patients treated with PN compared with those who underwent RN, but the patients treated with PN had a significantly better 10-year overall survival rate (94% vs. 89.7%). Both groups had similar cancer-specific survival.
The study, by Michael R. Daugherty, a fourth-year medical student, and Gennady Bratslavsky, MD, of SUNY Upstate Medical University in Syracuse, NY, included 222 patients who underwent PN and 494 who underwent RN.
Previous studies have demonstrated a survival advantage of PN in older patients, but these studies have been criticized because of selection bias in procedure selection due to comorbidities, the authors pointed out.
The investigators had hypothesized that the long-standing effects of renal preservation would manifest in a survival advantage of a younger patient population, where this selection bias is minimized.
"Any patients with a life expectancy of 10 years or more should be offered partial nephrectomy when technically feasible," the authors concluded in a poster presentation.