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    Partial Kidney Removal OK for Tumors?

    Study Shows Some Patients Unnecessarily Have Entire Kidney Removed
    By
    WebMD Health News
    Reviewed by Louise Chang, MD

    Feb. 13, 2008 -- Are some people unnecessarily losing a kidney? That's the question raised by a new study that suggests that people with small kidney tumors are typically referred for surgical removal of the entire kidney even though kidney-conserving surgery is just as effective.

    Researcher William Huang, MD, assistant professor of urologic oncology at New York University School of Medicine, says that due to their small size, over half of newly diagnosed kidney tumors are amenable to partial nephrectomy. Partial nephrectomy involves removal of the tumor and surrounding tissue, sparing the rest of the kidney.

    Partial nephrectomy is just as likely to cure small kidney tumors -- "those less than 4 centimeters, and in some cases even up to 7 centimeters, in diameter" -- as removal of the entire affected kidney, Huang says. "Despite this, four in five patients with small kidney tumors are having their whole kidney removed.

    "Just as lumpectomy can be less invasive but as effective as mastectomy for treating breast cancer, people with kidney cancer should be aware that partial nephrectomy is not only an option, but may be a better option than radical nephrectomy in many circumstances," Huang says.

    Preserving Kidney Function

    Howard M. Sandler, MD, a radiation oncologist at the University of Michigan who moderated a news briefing to discuss the findings, agrees that kidney-conserving surgery should be offered whenever possible.

    That's because a partial nephrectomy can preserve the kidney and long-term kidney function, he says

    While you can live with one kidney, Sandler notes that all our organs naturally lose function as we age.

    "You'll run out of function earlier if you only have one kidney," he tells WebMD.

    Huang says the incidence of kidney tumors is rapidly rising, with a 3% increase each year for the past 20 years; about 51,000 new kidney tumors will be diagnosed in the U.S. in 2008.

    Huang and colleagues combed through the NCI's Surveillance, Epidemiology and End Results (SEER) database from 1995 to 2002, comparing the characteristics of 2,547 patients with small renal tumors who had radical nephrectomy and 556 who had partial nephrectomy. A radical nephrectomy is surgical removal of the whole kidney.

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