Removal of an entire kidney doesn't prolong lives of patients aged 75 and above who have confined kidney tumours, says a new study.
In fact, they suffer from other medical problems, which should be given due cancer-related care, such as observation or treatments that spare the non-cancerous parts of their kidneys.
AdvertisementTo investigate if surgical kidney removal, or nephrectomy, improves survival when compared with active monitoring or kidney-sparing surgery, Steve Campbell, of the Cleveland Clinic and his colleagues conducted a study.
The doctors analysed information from 537 patients with localized kidney tumours that were 7cm in diameter and were detected at age 75 years or older.
Twenty percent of these patients were closely observed, 53 percent had kidney-sparing surgery, and 27 percent underwent a nephrectomy.
After following up for 4 years, 28 percent of patients died, the most common cause of death being heart-related (29 percent). Cancer progression was responsible for only four percent of deaths. Older age and additional medical conditions increased patients' risk of dying during the follow-up period, but choice of treatment did not.
Surgical removal of kidney seemed to indicate accelerated dysfunction of the remaining kidney and also appeared to increase patients' risk of dying from cardiovascular causes.
"Current research is indicating over-treatment of localized renal tumors, and our data suggest that active surveillance is a reasonable strategy and one that is greatly under-utilised in the elderly population," the authors wrote.
They added that the potential benefit of kidney-sparing surgery in elderly patients who have the lowest risk for heart-related deaths and the greatest life expectancy warrants further investigation.
The study is published online in CANCER, a peer-reviewed journal of the American Cancer Society.
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