Navigation Links
Surgeon's Preferences Dictate Choice of Kidney Cancer Surgery

Candidates for less radical procedures may not be getting them, study says

MONDAY, March 10 (HealthDay News) -- A surgeon's skills and preferences may dictate treatment choices for kidney cancer more than clinical factors such as tumor size or the patient's general health, a new study finds.

This means many patients who are candidates for less radical surgical procedures, such as a partial nephrectomy where only part of the kidney is removed, may not be getting them, the California researchers said.

"The world of medicine is slow to incorporate new technology," acknowledged Dr. Patrick Lowry, an assistant professor of surgery at Texas A&M Health Science Center College of Medicine. "It's kind of like a family tree. When more people are trained in it, they go out and spread it to others."

"Partial nephrectomy is more difficult and has more potential complications, and people may shy away from it," added Lowry, who's also section head of laparoscopy and endourology at Scott & White Memorial Hospital in Temple.

Radical nephrectomy, or removing the entire kidney, remains the gold standard for treating early-stage kidney cancer. While the procedure has a greater than 90 percent cure rate, it increases the risk of developing chronic kidney disease, the study authors said.

Over the past two decades, partial nephrectomy and laparoscopy (minimally invasive surgery) have started to make inroads in the field. These newer alternatives are easier on the patient and equally effective at controlling the cancer, yet not used anywhere nearly as often as radical nephrectomy, the researchers noted.

"On a national level, less than half of patients are getting one or the other [partial nephrectomy or laparoscopy] for small tumors," said study author Dr. David Miller, a clinical instructor in urology at the University of California, Los Angeles. "The question is whether there's some reason at a patient level, or that physicians are not doing these procedures for one of any number of a variety of reasons. We tried to quantify that."

For the study, the researchers looked at 5,483 Medicare beneficiaries who had undergone surgery for localized kidney cancer between 1997 and 2002. The study was part of the Urologic Diseases in America Program, funded by the National Institute of Diabetes and Digestive and Kidney Diseases.

Slightly more than 11 percent of the patients had a partial nephrectomy (43 performed laparoscopically) while the vast majority -- 88.9 percent -- had the entire kidney removed (515 laparoscopically).

The findings will be published in the April 15 issue of Cancer.

"For partial nephrectomy, the only thing that explained more of the variation in use than the surgeon you saw was the size of the tumor," Miller said. "For laparoscopy, the surgeon was more important than any other characteristic."

"If we believe as a specialty and as a society that newer procedures are beneficial, we have to think about how to tackle it," he added.

Patients also have a role to play in guiding their care, Miller said.

"Patient education and understanding and self-advocacy are important in discussing, with the primary doctor or urologist or surgeon," the treatment options, he said.

For instance, patients can ask questions like: "'What are the different treatment options available for this tumor? I've heard about partial nephrectomy. Is that a possibility in my case and, if it's not, why isn't it? If you think the whole kidney needs to be removed, what about the possibility of having it done with less invasive surgery?'" Miller said.

More information

The U.S. National Cancer Institute has more on kidney cancer.

SOURCES: David Miller, M.D., clinical instructor, urology, University of California, Los Angeles, David Geffen School of Medicine; Patrick Lowry, M.D., assistant professor, surgery, Texas A&M Health Science Center College of Medicine, and section head, laparoscopy and endourology, Scott & White Memorial Hospital, Temple; April 15, 2008, Cancer

Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. MedHelp to Add Top Stanford Surgeons and Specialized Forums to Online Health Community
2. Surgeons Remove Gallbladder Through Vagina
3. CRH Medical to exhibit at American College of Surgeons Annual Clinical Congress
4. Cosmetic Surgeons Gather in Dubai for World Congress, Hospital Opening
5. Starion Instruments Launches Next-Generation Tissue Ligating Shears at the American College of Surgeons Clinical Congress
6. Patients should ask surgeons about using honey to heal wounds
7. Expert Neurosurgeons and Neuro-oncologists to Speak at 6th Annual Brain Tumor Awareness Day Convention
8. Survey shows gender differences are factor when surgeons in training choose a subspecialty
9. American College of Surgeons Comments on JAMA Article on Surgeon Shortage
10. Holiday Hand Safety 101: Hand Surgeons Offer Tips for a Safe Carving Season
11. Over 600 Surgeons Certified to use TruFUSE(R) to Treat Back Pain Sufferers
Post Your Comments:
Related Image:
Surgeon's Preferences Dictate Choice of Kidney Cancer Surgery
(Date:11/25/2015)... Los Angeles, CA (PRWEB) , ... November 25, 2015 , ... ... advanced da Vinci surgical robot is being more and more widely heralded as a ... robotic assisted da Vinci method has over traditional laparoscopic surgery is that it can ...
(Date:11/25/2015)... IL (PRWEB) , ... November 25, 2015 , ... The ... announce a recent successful appellate decision obtained by Attorneys Francisco J. Botto and Alex ... Adcock v. Illinois Workers’ Compensation Comm’n, 2015 IL App (2d) 130884WC. , According to ...
(Date:11/25/2015)... ... 25, 2015 , ... Brillianteen, McGaw YMCA’s student-produced musical show, ... 65th Anniversary Brillianteen Revue, scheduled for March 4-6, 2016. Auditions for this final ... has been a treasured tradition for numerous families in the Evanston community. Over ...
(Date:11/25/2015)... Spring, Md (PRWEB) , ... November 25, 2015 ... ... Pulmonary Hypertension Association (PHA) announces the nation’s Periwinkle Pioneers, individuals and groups responsible ... history of this disease. The Periwinkle Pioneers, nominated by the public, will receive ...
(Date:11/25/2015)... ... 25, 2015 , ... Bcureful—a non-profit organization devoted to advancing ... public awareness of the disorder while helping to bring expert medical care and ... bolster progress at the Tuberous Sclerosis Complex Center at Ann & Robert H. ...
Breaking Medicine News(10 mins):
(Date:11/25/2015)... Frankreich, November 25, 2015 ... dass sie eine Lizenz für das Patent über eine ... UCBL und ENS-Lyon innehaben, an Enyo Pharma vergeben haben. ... AAP8 ins Leben gerufenen und von Edelris gemeinsam mit ... als ein Behandlungsziel für HBV identifiziert, und es wurden ...
(Date:11/24/2015)... The hope of bearing a ... IVF cycles. After failure of over 15 IVF cycles, ... all hopes that she would be able to conceive ever. But finally optimism prevailed as ... failure of over 15 IVF cycles. ... take one last attempt with Gaudium IVF Center in ...
(Date:11/24/2015)... 2015  Thanks to a donor with a personal ... Center,s Sister Diane Grassilli Center for Women,s Health now ... San Francisco . Fred ... with a gift of $617,320 that allowed the Center ... Tomosynthesis and Whole Breast Ultrasound. Tomosynthesis, three-dimensional (3-D) mammography ...
Breaking Medicine Technology: