Partial Nephrectomy Better for Certain Kidney Cancer Patients

It preserves kidney function better than radical nephrectomy in patients with small- to medium-sized tumors, study finds.

Partial nephrectomy patients may experience less kidney function decline after surgery.
Partial nephrectomy patients may experience less kidney function decline after surgery.

Partial nephrectomy (PN) should be the surgery of choice for renal cell carcinoma (RCC) tumors up to 7 cm in diameter, researchers concluded.

Radical nephrectomy (RN), by comparison, is associated with significantly more cases of acute kidney injury (AKI) and new-onset chronic kidney disease (CKD); it was also an independent risk factor for kidney function decline.

“We hope that the findings of this study will help enhance surgical treatment and improve clinical outcomes for patients with RCC,” wrote study author Chang Seong Kim, MD, PhD, and colleagues from Chonnam National University Medical School in Korea.

For the study, which was published online ahead of print in BMC Nephrology, the investigators analyzed the medical records of 557 patients with RCC tumors up to 7 cm in diameter. PN was performed on 39% of patients; 61% of patients underwent RN. 

During 3 years of follow-up, RN patients experienced greater kidney function decline than PN patients. Their estimated glomerular filtration rates were significantly lower, and the incidences of AKI (70.1% vs. 24.3%) and new-onset CKD (55.7% vs. 6.2%) were significantly higher.

The study findings add needed information on RCC treatment based on type of surgery, tumor size, and post-surgical kidney function, according to the investigators.

Source

  1. Kim, CS et al. BMC Nephrology. 2014; doi: 10.1186/1471-2369-15-181
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