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Nephron-Sparing Surgery Possible When Treating Renal Cancer
01/09/2008
| By medinews.com staff writers Posted on 09 January 2008 |
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| Nephron-sparing surgery is a safe alternative to radical nephrectomy in selected patients with locally advanced renal cell carcinoma, according to a new study. Researchers at the University of Texas MD Anderson Cancer Center (Houston, TX, USA) retrospectively studied data on 567 patients treated with radical nephrectomy and 34 who underwent the nephron-sparing procedure. Indications for this approach included a solitary kidney and chronic renal insufficiency. The patients were followed for a mean of 43.4 months. The researchers found that there was disease recurrence in 29.9% of the radical nephrectomy group at a median of 13.2 months; in the sparing group, on the other hand, the corresponding proportion was 12% at a median of 24.2 months, and there were no local recurrences in these patients. However, 9% of the patients experienced procedure-related complications, compared to only 2.9% in the radical nephrectomy group. Overall outcomes were comparable, with apparently similar intraoperative blood loss, surgery duration, and hospital stay. The study was published in the December 2007 issue of the British Journal of Urology (BJU) International. “Locally advanced renal cell carcinoma does not preclude consideration of nephron-sparing approaches,” said lead author Christopher G. Wood, M.D., an associate professor of urology and cancer biology. “Tumor size or even, in some cases, stage, is not the most important predictor of success in partial nephrectomy, but rather tumor location.” The researchers concluded that the nephron-sparing technique should be extended to all patients in whom complete local excision of the tumor with preservation of the functional renal remnant is technically feasible. |