Partial Nephrectomy Offers Better Survival

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Partial nephrectomy (PN) is associated with better overall survival compared with radical nephrectomy (RN) in patients who have benign renal tumors, according to investigators at Cleveland Clinic in Ohio.

Christopher J. Weight, MD, and colleagues at the clinic's Glickman Urological & Kidney Institute studied a subset of patients who underwent extirpative surgery for suspected malignant tumors but who turned out to have benign tumors based on pathologic examination. Of 2,608 consecutive clinical T1 renal tumors, 500 (19%) were found to be benign. The median follow-up was 50 months.

The five-year overall survival estimate for the 389 PN patients was 95% compared with 83% for 111 RN patients. In addition, RN patients on average were older than PN patients (68 vs. 62 years) and had larger tumors (4.0 vs. 2.8 cm in diameter). After controlling for comorbidities and age, RN was associated with at least a twofold increased risk of death compared with PN.

The researchers concluded that if a benign renal tumor is suspected pre-operatively either by biopsy, radiographic, or demographic information, “every effort should be made to offer a partial nephrectomy.”

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