Bottom Line: For tumors less than 4 cm, there is no increase in the risk of death from kidney cancer. Surveillance is a safe alternative to surgery for small kidney cancers.
William Huang, MD, a surgical oncologist at New York University Langone Medical Center set out to identify the effect of surveillance of small renal (kidney) tumors on morbidity and mortality, as compared to surgery. The retrospective series included 8,300 patients who were 66 years of age or older, with kidney tumors less than 4cm. Of these, 78% had surgery and 22% had surveillance. At a median follow-up of 5 years, patients in the surveillance group had a 16% lower risk of death from any cause compared with the surgical group. Kidney cancer-specific mortality did not differ significantly between the groups.
My take: Surveillance is a reasonable option, especially for those who have a limited life expectancy. Because some tumors can become lethal over time, if you have a reasonable life expectancy, surgery remains the gold standard for management. Still, it is nice to know that selected patients are potential candidates for surveillance, avoiding potential cardiovascular complications. I’m Dr. Michael Hunter.
2013 Genitourinary Cancers Symposium, Abstract 343.
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