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Surgeon's Preferences Dictate Choice of Kidney Cancer Surgery
Date:3/10/2008

ent 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., clinic
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