For patients with kidney tumors, a new study shows the health and economic advantages to removing just the tumor as opposed to the entire kidney. Robotic surgery, including the daVinci Surgical System and Firefly fluorescence imaging that lights up kidney tumors, are among the latest techniques to make this possible.
The retrospective study conducted by MedStar Georgetown University Hospital Urologist Keith Kowalczyk, MD, is published in the March issue of the British Journal of Urology International. It compares the effectiveness, costs and trends in the treatment of kidney tumors less than four centimeters in size. The study found that partial kidney removal, whether open or laparoscopic, leads to better overall survival and fewer health problems after surgery. Additionally, minimally invasive approaches to partial kidney removal resulted in to shorter length of hospital stay and lower costs.
"The study says that patients who underwent the partial kidney removal for kidney cancer tended to live longer because sparing the remaining kidney allowed them to avoid medical complications of kidney failure afterwards," said Dr. Kowalczyk. "The more of the kidney you can keep, the more kidney function you'll have after the tumor is removed, and the better you will do."
"In the 1980s and early '90s the standard of care was to remove the whole kidney unless surgeons had other contra-indications for example if the patient only had one kidney or tumors on both sides," said Dr. Kowalczyk. "Over the last 10 years, studies have suggested that partial kidney removal is just as good at curing the cancer as removing the whole tumor, and at the same time has the additional benefit of sparing crucial kidney function. This study reinforces on a greater scale that leaving the healthy part of the kidney benefits the patient in terms of cancer survival, overall survival, costs, and fewer postoperative complications. Additionally, doing the partial removal via a minimally invasive approach, when possible, leads to quicker recovery," said Dr. Kowalczyk.
This study, based on 1682 Medicare patients from twenty regions in the United States between 2005 and 2007, shows how partial nephrectomy for kidney tumors can also decrease healthcare costs and helps the overall healthcare system.