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Partial Nephrectomy Use Low for Renal Cell Carcinoma

Use of laparoscopic radical nephrectomy may have influenced decline in partial surgery

MONDAY, Feb. 1 (HealthDay News) -- The use of laparoscopic radical nephrectomy may have reduced the use of partial nephrectomy for renal cell carcinoma, according to research published in the February issue of The Journal of Urology.

Robert Abouassaly, M.D., of the University of Toronto, and colleagues analyzed data from the Ontario Cancer Registry on 7,830 patients treated surgically for renal cell carcinoma in Ontario from 1995 to 2004.

Of these patients, 7,042 (89.9 percent) underwent radical nephrectomy, and the remainder underwent partial nephrectomy. Before January 2003, the odds of partial nephrectomy increased by 18 percent annually, the authors note; however, after this time, the odds fell by 12 percent per year until the end of 2004. Patients receiving partial nephrectomy were younger than those receiving radical nephrectomy (57 versus 60.4 years).

"The rate of partial nephrectomy for renal cell carcinoma remains low. Laparoscopic radical nephrectomy may have negatively impacted the uptake and use of partial nephrectomy for renal cell carcinoma. With increasing evidence that cardiovascular morbidity is associated with renal function, this raises an important quality of care concern. The uncommon use of nephron sparing surgery is especially evident in elderly patients, who may benefit the most from this approach. More recent data and data from other jurisdictions will determine whether these trends persist and may be generalized," the authors conclude.

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