Our Summary

This research paper is about a study comparing two types of kidney tumor surgeries: partial nephrectomy (PN) and radical nephrectomy (RN). The study was done to find out which one is better for treating complex kidney tumors.

In the study, they looked at previous research published before November 2023 from different databases. They selected six studies that directly compared the two surgical methods, totaling 2602 patients.

They found that the PN surgery took longer to perform, had a higher chance of major complications, and patients lost more blood during the surgery. However, patients who underwent PN had a smaller decrease in kidney function. There was no significant difference between the two surgeries in terms of minor complications, how long patients stayed in the hospital, and the need for blood transfusion.

When looking at how successful the surgeries were in terms of cancer outcomes, patients who had PN surgery lived longer and had a longer cancer-specific survival time. There was no significant difference in the recurrence-free survival time (the time during which the patient remains free from cancer recurrence) between the two surgeries.

In conclusion, PN surgery may take longer and have a higher chance of major complications in the short term, but in the long run, it has less impact on kidney function and patients live longer.

FAQs

  1. What is the difference between partial nephrectomy and radical nephrectomy in treating complex renal tumours?
  2. What are the complications associated with partial nephrectomy (PN) compared to radical nephrectomy (RN) for complex renal tumors?
  3. How does the long-term outcomes of partial nephrectomy compare to those of radical nephrectomy in complex renal tumors treatment?

Doctor’s Tip

One helpful tip a doctor might tell a patient about nephrectomy is to discuss the potential benefits and risks of both partial nephrectomy (PN) and radical nephrectomy (RN) for the treatment of complex renal tumors. While PN may have a longer operative time and increased complications in the short term, it may offer better long-term outcomes in terms of renal function and survival. It is important for patients to have a thorough discussion with their healthcare provider to determine the best treatment option for their individual situation.

Suitable For

Patients with complex renal tumors, specifically those with a RENAL or score ≥ 7, are typically recommended for nephrectomy. In this study, it was found that partial nephrectomy (PN) may be superior to radical nephrectomy (RN) for the treatment of these complex renal tumors, as it was associated with longer overall survival (OS) and cancer-specific survival (CSS) with a smaller decrease in renal function in the long term. However, it should be noted that PN did have longer operative times, increased estimated blood loss, and higher rates of major complications compared to RN in the short term. Ultimately, the decision between PN and RN for complex renal tumors should be made based on individual patient factors and preferences, as well as the expertise of the surgical team.

Timeline

  • Before nephrectomy:
  1. Patient is diagnosed with a complex renal tumor (RENAL score ≥ 7).
  2. Patient undergoes imaging studies to assess the size and location of the tumor.
  3. Treatment options, including partial nephrectomy (PN) and radical nephrectomy (RN), are discussed with the patient.
  4. Pre-operative tests and evaluations are conducted to assess the patient’s overall health and suitability for surgery.
  5. Patient receives counseling on the potential risks and benefits of the surgery.
  • After nephrectomy:
  1. Patient undergoes surgery, either PN or RN, to remove the renal tumor.
  2. Post-operative care includes monitoring for complications such as bleeding, infection, and changes in renal function.
  3. Patient may experience pain and discomfort in the surgical site.
  4. Recovery and rehabilitation process begins, including physical therapy and follow-up appointments with the healthcare team.
  5. Long-term follow-up is conducted to assess oncologic outcomes such as overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS).
  6. Patient may experience changes in renal function, with PN showing a smaller decrease in function compared to RN.
  7. Overall, PN is associated with longer OS and CSS compared to RN for complex renal tumors.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with undergoing a nephrectomy?
  2. How will my kidney function be affected after the surgery?
  3. What is the difference in recovery time between partial nephrectomy and radical nephrectomy?
  4. How will my quality of life be impacted after the surgery?
  5. What is the likelihood of the cancer recurring after a nephrectomy?
  6. Are there any alternative treatment options to consider before deciding on a nephrectomy?
  7. Will I need any additional treatments or follow-up care after the surgery?
  8. How experienced are you in performing nephrectomy procedures?
  9. Can you provide me with information on the success rates of partial nephrectomy versus radical nephrectomy for complex renal tumors?
  10. Are there any specific dietary or lifestyle changes I should make before or after the surgery to optimize my recovery?

Reference

Authors: Zeng Z, Ge S, Li Y, Gan L, Meng C, Li K, Wang Z, Zheng L. Journal: Ann Surg Oncol. 2024 Jul;31(7):4762-4772. doi: 10.1245/s10434-024-15223-x. Epub 2024 Apr 17. PMID: 38630418