Survival advantage for partial nephrectomy questioned by new study

Small renal tumours can be treated by either complete (radical) or partial nephrectomy. Over the past few years, there has been a trend to use partial nephrectomy where possible, despite the higher complication rate from this surgery. This trend has been driven by evidence that overall survival is better in patients treated by partial nephrectomy, perhaps because kidney function is preserved, which in turn may have beneficial effects on overall health. A study published in May from Yale School of Medicine and the National Cancer Institute questions this belief, with evidence that the survival benefit seen with partial nephrectomy may actually be due to 'selection bias'. This means that the survival benefit may be due to the fact that healthier patients were chosen for partial nephrectomy, and they would have survived longer regardless of treatment option.

In summary, our current understanding is that both treatment options are reasonable for patients with small kidney tumours. Partial nephrectomy, where possible, is favourable for those patients who have reduced renal function, or have a disease that may make them prone to kidney problems later in life, such as diabetes and high blood pressure.

The following link takes you to a summary of the study

Link
Overall survival advantage with partial nephrectomy: A bias of observational data?