Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Radical surgery for kidney cancer is risk factor for chronic kidney disease

07.09.2006
For forty years, the gold standard for treating a single, small tumor in the kidney has been to remove the entire kidney. A retrospective study, which appears in the September issue of The Lancet Oncology, by urologists at Memorial Sloan-Kettering Cancer Center (MSKCC) and their colleagues, suggests that this practice needs to be re-evaluated.

Researchers add that with advances in imaging, almost 70 percent of kidney cancer patients have their tumor detected at a very small size (less than 4 cm), allowing surgeons to perform less radical surgery with superior results.

The study revealed that patients with two otherwise healthy kidneys who underwent kidney-sparing surgery (partial nephrectomy) to remove a small cancer developed chronic kidney disease at a rate one-third lower than patients whose entire kidney was removed (radical nephrectomy). The three-year probability of staying free of chronic kidney disease was 80 percent for the partial nephrectomy patients compared with 35 percent for patients who underwent a radical nephrectomy. In fact, radical nephrectomy was shown to be a significant risk factor for developing chronic kidney disease.

"The results of our study demonstrate that prior to surgery, the baseline kidney function of patients with small kidney tumors was significantly lower than previously recognized," explained Dr. William C. Huang, the study's first author. "Patients who undergo a radical nephrectomy, the most common treatment for small kidney tumors, are at significantly greater risk for the development of chronic kidney disease after surgery compared with those who undergo a partial nephrectomy."

The retrospective study of 662 patients at MSKCC showed that up to 26 percent of the patients had pre-existing chronic kidney disease before undergoing surgery to remove a small tumor (less than 4 cm) from the kidney. In addition, those patients who had the entire kidney removed were more than twice as likely to develop chronic kidney disease.

Although partial nephrectomies account for 30 to 65 percent of all kidney surgeries performed in tertiary care centers in the United States like MSKCC, the latest analysis from the Nationwide Inpatient Sample reported in the journal Urology indicated that 92.5 percent of all kidney cancer surgeries in the United States from 1998 to 2002 were radical nephrectomies. Statistics from the Department of Health in England for the same period reflected a similar trend. In 2002, 96 percent (2,671) of kidney cancer surgeries performed in England were nephrectomies and 4 percent (108) were partial nephrectomies.

"Evidence has accumulated from our Center and elsewhere that partial nephrectomy provides effective local tumor control and equivalent survival rates to that of radical nephrectomy for small tumors," said Dr. Paul Russo, the study's senior author. "However, while approximately 70 percent of kidney tumor operations at MSKCC are partial nephrectomies, national databases from the United States and abroad suggest that greater than 80 percent of patients may be unnecessarily undergoing the more radical surgery to remove the entire kidney, even for small renal tumors. One explanation may be that partial nephrectomy is a more complex surgical procedure."

A number of risk factors for chronic kidney disease, such as diabetes, hypertension, and smoking, are commonly found in patients with kidney tumors, and may account for why the majority of these patients are at risk for developing chronic kidney disease following a radical nephrectomy. Chronic kidney disease can result in the loss of kidney function, sometimes leading to kidney failure. Complications associated with chronic kidney disease include anemia, hypertension, malnutrition, and neuropathy, as well as a reduced quality of life, and even heart disease and death.

"Our study clearly demonstrates, for the first time, the serious effects on kidney function and the high risk of chronic kidney disease when an entire kidney is removed for a small cancer. Chronic kidney disease leads to an increased risk of cardiovascular events, hospitalizations, and even death," said Dr. Peter T. Scardino, Chairman of the Department of Surgery and co-author of the study. "By removing only the cancerous part, we are much more likely to preserve a patient's normal kidney function and avoid the long-term consequences of chronic kidney disease."

Joanne Nicholas | EurekAlert!
Further information:
http://www.mskcc.org

More articles from Health and Medicine:

nachricht GLUT5 fluorescent probe fingerprints cancer cells
20.04.2018 | Michigan Technological University

nachricht Scientists re-create brain neurons to study obesity and personalize treatment
20.04.2018 | Cedars-Sinai Medical Center

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: BAM@Hannover Messe: innovative 3D printing method for space flight

At the Hannover Messe 2018, the Bundesanstalt für Materialforschung und-prüfung (BAM) will show how, in the future, astronauts could produce their own tools or spare parts in zero gravity using 3D printing. This will reduce, weight and transport costs for space missions. Visitors can experience the innovative additive manufacturing process live at the fair.

Powder-based additive manufacturing in zero gravity is the name of the project in which a component is produced by applying metallic powder layers and then...

Im Focus: Molecules Brilliantly Illuminated

Physicists at the Laboratory for Attosecond Physics, which is jointly run by Ludwig-Maximilians-Universität and the Max Planck Institute of Quantum Optics, have developed a high-power laser system that generates ultrashort pulses of light covering a large share of the mid-infrared spectrum. The researchers envisage a wide range of applications for the technology – in the early diagnosis of cancer, for instance.

Molecules are the building blocks of life. Like all other organisms, we are made of them. They control our biorhythm, and they can also reflect our state of...

Im Focus: Spider silk key to new bone-fixing composite

University of Connecticut researchers have created a biodegradable composite made of silk fibers that can be used to repair broken load-bearing bones without the complications sometimes presented by other materials.

Repairing major load-bearing bones such as those in the leg can be a long and uncomfortable process.

Im Focus: Writing and deleting magnets with lasers

Study published in the journal ACS Applied Materials & Interfaces is the outcome of an international effort that included teams from Dresden and Berlin in Germany, and the US.

Scientists at the Helmholtz-Zentrum Dresden-Rossendorf (HZDR) together with colleagues from the Helmholtz-Zentrum Berlin (HZB) and the University of Virginia...

Im Focus: Gamma-ray flashes from plasma filaments

Novel highly efficient and brilliant gamma-ray source: Based on model calculations, physicists of the Max PIanck Institute for Nuclear Physics in Heidelberg propose a novel method for an efficient high-brilliance gamma-ray source. A giant collimated gamma-ray pulse is generated from the interaction of a dense ultra-relativistic electron beam with a thin solid conductor. Energetic gamma-rays are copiously produced as the electron beam splits into filaments while propagating across the conductor. The resulting gamma-ray energy and flux enable novel experiments in nuclear and fundamental physics.

The typical wavelength of light interacting with an object of the microcosm scales with the size of this object. For atoms, this ranges from visible light to...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Invitation to the upcoming "Current Topics in Bioinformatics: Big Data in Genomics and Medicine"

13.04.2018 | Event News

Unique scope of UV LED technologies and applications presented in Berlin: ICULTA-2018

12.04.2018 | Event News

IWOLIA: A conference bringing together German Industrie 4.0 and French Industrie du Futur

09.04.2018 | Event News

 
Latest News

Complete skin regeneration system of fish unraveled

24.04.2018 | Life Sciences

Scientists create innovative new 'green' concrete using graphene

24.04.2018 | Materials Sciences

BAM@Hannover Messe: innovative 3D printing method for space flight

24.04.2018 | Trade Fair News

VideoLinks
Science & Research
Overview of more VideoLinks >>>