Many kidney cancer patients may be overtreated, study suggests

More than 90% of patients with small kidney tumors are opting to undergo total nephrectomy, even though they may be eligible for partial nephrectomy, according to a recently published study from the University of Michigan Comprehensive Cancer Center, Ann Arbor.

The study involved 14,647 patients treated from 1988 to 2001 for kidney cancers less than 7 cm in size. Only 9.6% of patients were treated with partial nephrectomy, while the remaining patients had the entire kidney removed, researchers reported in the March Journal of Urology (2006; 175:853-7). The smaller the tumor, the more likely patients were to receive partial nephrectomy.

The researchers suggest that one possible explanation for the finding is that total nephrectomy is more likely to be performed with minimally invasive laparascopic surgery.

“For most surgeons, partial nephrectomy, whether open or laparoscopic, is likely to be a more difficult operation than removing the entire kidney,” said study co-author David Miller, MD. “Many surgeons are able to take the whole kidney out laparoscopically, but are less experienced performing partial nephrectomy laparoscopically.”