Partial nephrectomy may offer longer survival

Kidney cancer patients who underwent partial nephrectomy experienced better survival than patients who underwent radical nephrectomy, report researchers from the University of Michigan Comprehensive Cancer Center, Ann Arbor.

After an average of 5 years, 25% of patients who had a partial nephrectomy had died compared with 42% of patients who underwent radical nephrectomy, according to the authors, who published their findings in JAMA (2012; 307:1629-35).

"For patients who are candidates for partial nephrectomy, it should be the preferred treatment option. We found that patients who were younger or had pre-existing medical conditions benefited most from partial nephrectomy," said first author Hung-Jui Tan, MD.

Dr. Tan and colleagues looked at 7,138 Medicare beneficiaries with early-stage kidney cancer up to 8 years after treatment. Patients were equally likely to die of kidney cancer, regardless of the type of surgery they received. The survival discrepancy was found in the number of patients who died from any cause.

The study showed that if only seven patients chose partial nephrectomy over radical nephrectomy, it would save one extra life.

"As more and more people are identified with small, early-stage cancers, there’s more interest in understanding how best to treat these patients," said senior author David C. Miller, MD, MPH. "This study does not suggest every patient with early-stage kidney cancer should get a partial nephrectomy. It supports the notion that we need to expand the use of partial nephrectomy and make it a preferred treatment choice for patients with small tumors as much as possible, to optimize long-term survival."

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