Navigation Links
Research suggests doctors should consider kidney-sparing surgery
Date:10/1/2008

WINSTON-SALEM, N.C A study of almost 1,500 kidney cancer patients treated at Memorial Sloan Kettering Cancer Center suggests that surgery to spare as much kidney tissue as possible may improve overall survival in patients who also have reduced kidney function at the time their cancer is diagnosed. The finding is significant because both kidney cancer and decreased kidney function appear to be increasing.

"In patients who have the combination of kidney cancer and lowered kidney function, doctors should consider tissue-sparing surgery versus complete removal whenever it is technically feasible," said Joseph Pettus, M.D., lead author and now an assistant professor of urology at Wake Forest University School of Medicine. "Currently this option is significantly underused."

Reporting in the Mayo Clinic Proceedings, a peer-reviewed medical journal, researchers found that among patients having surgery for kidney cancer, those who also had severely impaired kidney function were almost three times more likely to die than patients with normal kidney function.

Impaired kidney function can sometimes be related to the cancer itself. But impaired function can also be caused or compounded by a variety of other factors, including diabetes, hypertension and vascular disease. Impaired kidney function itself even without a diagnosis of cancer is related to increased risk of death and hospitalization.

Surgery to remove a malignant tumor can further impair kidney function because the loss of kidney tissue affects kidney function over time. Researchers at Memorial Sloan Kettering had previously found that patients whose kidneys were completely removed were almost 12 times more likely to develop significantly impaired function in the remaining kidney than patients whose organs were partially removed.

The study involved an analysis of data from kidney cancer patients treated during a 10-year period. Pettus conducted the research with colleagues at Sloan Kettering before moving to Wake Forest.

The research was based on the hypothesis that kidney cancer patients with reduced kidney function prior to surgery would have lower survival rates than cancer patients with normal kidney function. The researchers excluded patients whose disease had spread to the lymph nodes or other parts of the body.

They found that median beginning levels of kidney function in all patients decreased during the 10-year period by about 10 percent. Compared to those with normal kidney function, patients who began with moderately reduced function were 150 percent more likely to die from any cause. Those with severely reduced function were almost three times (280 percent) more likely to die.

Pettus said the findings suggest that obesity and related diseases that affect kidney function may be contributing to the rising death rates from kidney cancer. Overall death rates increased 323 percent among kidney cancer patients between 1983 and 2002 despite the fact that the disease is being detected earlier. He said that rising rates of kidney cancer combined with a decline in kidney function is almost a "perfect storm" scenario which may explain the decrease in survival, even among patients with early stages of kidney cancer.

"These findings underscore the importance of considering baseline kidney function when devising treatment plans for patients with kidney tumors," said Pettus.

He said the findings raise concerns that surgery may result in more medical harm than benefit to treating the cancer.

"Our data beg the question of whether patients with moderate to severe kidney disease and small tumors might be better managed through tissue-sparing techniques or a 'watchful waiting' approach," said Pettus. "Completely removing the kidney may result in more harm than good, particularly in elderly patients with small tumors and other medical problems. For these patients, careful surveillance may be a legitimate option with surgery reserved for cases where the tumor increases in size."

Research has shown that for tumors that are 7 cm or less, partial removal of the kidney provides equal cancer control to total removal. However, partial removal accounted for only 7.5 percent of kidney surgeries between 1988 and 2002. And for smaller tumors, only 20 percent were treated with partial removal of the kidney.


'/>"/>

Contact: Karen Richardson
krchrdsn@wfubmc.edu
336-716-4453
Wake Forest University Baptist Medical Center
Source:Eurekalert

Related medicine news :

1. The Leukemia & Lymphoma Society Awards Major Grant to Stanford Researcher
2. Researchers create first model for retina receptors
3. Scripps Research Institute and IAVI launch worlds first dedicated HIV neutralizing antibody center
4. NIH Awards a Phase I Small Business Innovative Research Grant on "Novel Laser Scanning Technology for Computed Radiography" to VIXAR and iCRco
5. Congress Sets New Course for Lung Cancer Research; Approves $20 Million for New Defense Department Program
6. OHSU Cancer Institute researcher: radiation, immunotherapy gives greater effectiveness
7. New research on hot topics in aging to be presented at GSAs Annual Scientific Meeting
8. Researchers Report Stem Cell Advance
9. MultiVu Video Feed: NEW RESEARCH PUBLISHED IN THE AMERICAN JOURNAL OF CLINICAL NUTRITION FINDS PISTACHIOS IMPROVE RISK FACTORS FOR HEART DISEASE
10. New Site Launched for Families and Scientists to Discuss Stem Cell Research (US)
11. Diabetes Research and Awareness Receives Big Boost Thanks to Generous Gift from Thomas McInerney
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/27/2017)... ... March 27, 2017 , ... Mt. ... launch of a months-long rebranding effort. This includes the introduction of new packaging ... discussions and market research, we learned that a simple, proactive approach to wellness ...
(Date:3/27/2017)... PORT RICHEY, Fla. (PRWEB) , ... March 27, ... ... U.S. drug overdose deaths soared 167%,(1) with opioids alone responsible for over 33,000 ... Assemblyman Kevin McCarty has sponsored Assembly Bill (AB) 1512, which proposes a tax ...
(Date:3/26/2017)... ... March 26, 2017 , ... ... the RealSelf 100 Award, a prestigious award honoring the top influencers on RealSelf—the ... find and connect with doctors and clinics. , In 2016, more than 82 ...
(Date:3/24/2017)... ... 2017 , ... Clean Earth, Inc., a leader in providing ... materials announced today the acquisition of privately owned AERC Recycling Solutions ... facilities and a vast array of additional technologies, services, and new markets to ...
(Date:3/24/2017)... ... March 24, 2017 , ... ... countries to hospitals in the United States, it’s a threat that is constantly ... obstacles facing infection prevention and offers strategies for the healthcare community to help ...
Breaking Medicine News(10 mins):
(Date:3/27/2017)... -- Invivotek, LLC, a Genesis Biotechnology Group ® ... contract research organization (CRO), announced the completion of the ... research facility in Hamilton, New Jersey ... source to reduce costs and lessen the CRO facility,s ... Farm follows Invivotek,s recent expansion from a 19,712 square ...
(Date:3/24/2017)... Calif. , March 24, 2017 /PRNewswire/ ... epigenetics company, and Hamilton Robotics, Inc., who ... announced an ongoing collaboration that teams Zymo ... and RNA and DNA extraction products with ... already created optimized methods for microbiomics and ...
(Date:3/24/2017)... , March 24, 2017 ... providing high-quality and cost-effective drug development and ... pharmaceutical and biotechnology industry, announced today the ... ShangPharma will be consolidating the Contract ... (CMO) under Shanghai ChemPartner. These entities include ...
Breaking Medicine Technology: