Surgery that involves only the removal of cancer while sparing the kidney (nephron-sparing surgery) is just as effective as removal of the entire kidney in patients with early stage kidney cancer, according to a recent article in the
Mayo Clinic Proceedings.
The kidneys are a pair of bean shaped organs located on each side of the spine. The kidneys filter the blood and eliminate waste in the urine through a complex system of filtration tubules. All of the blood in the body passes through the kidneys approximately 20 times an hour. Renal cell cancer is an uncommon form of cancer that is most often characterized by the presence of cancer cells in the lining of the filtration tubules of the kidney. Patients with early stage renal cell cancer often undergo the complete removal of the kidney in which the cancer exists (radical nephrectomy). However, nephron-sparing surgery (NSS) is being utilized with more frequency in the treatment of kidney cancer and researchers are evaluating data to determine optimal candidates for this type of therapy.
Researchers from the Mayo Clinic recently reviewed data and outcome of patients with kidney cancer who were treated at their facility between 1996 and 1999. All of these patients had kidney cancer confined to one kidney and one cancer-free kidney. According to the most recent follow-ups, 79% of NSS patients and 77% of patients undergoing a radical nephrectomy (RN) were cancer-free. According to 10 year follow-ups, the incidence of kidney failure was 22% in the RN group, compared with only 11% in the NSS group. The complication of kidney failure is significant, as these patients experience a substantial decrease in their quality of life and significant accrual of financial burden.
These results suggest nephron-sparing surgery may be just as beneficial as a radical nephrectomy without the serious side effects. Patients with early stage renal cancer may wish to speak with their physician about the risks and benefits of nephron-sparing surgery in their particular case. (Mayo Clinic Proceedings, December, 2000)