Memorial Sloan Kettering Cancer Center researchers have found that surgery to spare as much kidney tissue as possible may improve overall survival in patients who also have reduced kidney function at the time their cancer is diagnosed. The study is significant because both kidney cancer and decreased kidney function appear to be increasing.
Impaired kidney function can sometimes be related to the cancer itself. But impaired function can also be caused or compounded by a variety of other factors, including diabetes, hypertension and vascular disease. Impaired kidney function itself – even without a diagnosis of cancer – is related to increased risk of death and hospitalization. Surgery to remove a malignant tumor can further impair kidney function because the loss of kidney tissue affects kidney function over time.
Researchers at Memorial Sloan Kettering had previously found that patients whose kidneys were completely removed were almost 12 times more likely to develop significantly impaired function in the remaining kidney than patients whose organs were partially removed.
The study has used data from kidney cancer patients treated during a 10-year period. Pettus conducted the research with colleagues at Sloan Kettering before moving to Wake Forest.The study also suggests that obesity and related diseases that affect kidney function may be contributing to the rising death rates from kidney cancer.
Joseph Pettus, M.D., lead author of the study says,
“In patients who have the combination of kidney cancer and lowered kidney function, doctors should consider tissue-sparing surgery – versus complete removal – whenever it is technically feasible.”
He further says,
“Our data beg the question of whether patients with moderate to severe kidney disease and small tumors might be better managed through tissue-sparing techniques or a ‘watchful waiting’ approach.Completely removing the kidney may result in more harm than good, particularly in elderly patients with small tumors and other medical problems. For these patients, careful surveillance may be a legitimate option with surgery reserved for cases where the tumor increases in size.”
Source: EurekAlert
Filed under Health, Kidney
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