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

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

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