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Researchers examine procedure utilization trends in patients with clinically localized renal masses
Date:5/16/2011

the entire kidney, while partial nephrectomy techniques focus specifically on tumor removal while preserving as much functional kidney as possible. Either procedure may be performed via an open procedure through a large incision or a minimally invasive (or laparoscopic) approach.

In their study, researchers at Fox Chase demonstrated a dramatic 58 percent decrease in the percentage of open radical nephrectomy procedures performed from 1995 to 2005. However, they also observed more than a two-fold increase in laparoscopic nephrectomies in comparison to kidney sparing procedures over the same time period. These results suggest that more urologists are opting for laparoscopic nephrectomy, which may be due to increased familiarity and technical ease over more complex open or laparoscopic kidney preserving procedures. As a result, there is not the expected increase in the number of kidney preserving operations being performed, and more patients than necessary are being exposed to the adverse long-term consequences of chronic renal insufficiency.

"Knowing what we do about the long-term risks associated with removing a person's kidney, such as higher rates of long-term morbidity, it is crucial that, as physicians, we are doing all we can to spare as much of the organ as possible," says Robert G. Uzzo, M.D., F.A.C.S., chairman of the department of surgery at Fox Chase and member of the AUA Guidelines Council. "In this study, we're seeing a preference for laparoscopic procedures when we should be seeing a preference for nephron-sparing procedures."

To investigate this issue, Fox Chase identified 6,716 patients who underwent surgery for clinically localized renal masses between 1995 and 2005, drawn from linked SEER-Medicare data. They then compared utilization rates over time of four differing surgical procedures: open radical nephrectomy (ORN), laparoscopic radical nephrectomy (LRN), open partial nephrectomy (OPN), and laparoscopic partial ne
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Contact: Diana Quattrone
Diana.Quattrone@fccc.edu
215-728-7784
Fox Chase Cancer Center
Source:Eurekalert

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