Kidney Cancer Radical Surgery: A Risk Factor for Chronic Kidney Disease

Removing the entire kidney is the gold standard for 40 years in the treatment of a single, small tumor in the kidney.

A retrospective study appearing in the September issue of The Lancet Oncology suggests that such practice needs to be re-evaluated.

Urologists at the Memorial Sloan-Kettering Cancer Center (MSKCC) and their colleagues reported 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), thereby enabling surgeons to perform less radical surgery with superior results.

According to the results of the said study, 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).

Radical nephrectomy or the entire removal of a kidney has been shown to be a significant risk factor for developing chronic kidney disease.

In partial nephrectomy patients, the 3-year probability of staying free of chronic kidney disease is 80% compared to 35% in patients who underwent a radical nephrectomy.

According to Dr. Peter T. Scardino, Chairman of the Department of Surgery and co-author of the study:

“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. 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.”

Read the full report at MSKCC.