03 Jun Treatment For Small Kidney Cancers Has Evolved
Medical Research: What is the background for this study? What are the main findings?
Dr. Huang: The presentation of kidney cancers has dramatically evolved over the past two decades with most kidney cancers being incidentally diagnosed at an early stage. We have begun to recognize that at this small size (< 4 cm), the tumors are frequently indolent in nature and some are completely benign. Consequently, the management options for these small cancers have expanded and evolved. Whereas the entire removal of the kidney was the treatment of choice in the past, alternative options including removal or ablation of the tumor-bearing portion of the kidney has become increasingly utilized. Similar to other early stage cancers, watchful waiting or observation is also becoming a reasonable treatment option.
We used the most recent SEER-Medicare Data (2001 – 2009) to evaluate the management trends and outcomes of small kidney cancers in the new millennium. We believe that this is an important study as it provides important and practical findings, which are useful to both clinical researches as well as practicing physicians.
Medical Research: What should clinicians and patients take away from your report?
Dr. Huang: Clinicians and patients alike should note that the treatment paradigm for small kidneys cancers has evolved. Nephron-sparing surgery is now the most common treatment and appears to provide an overall and cancer-specific survival benefit over other options. Nonetheless, the risk of cancer related death is low in older patients with small kidney cancers regardless of treatment type, so non-surgical management is an acceptable option for some patients. Despite this findings, use of non-surgical treatment remains low.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Huang: In the future, we will need to prospectively validate the findings from this population based study. Additionally, we will need to find novel methods of identifying which tumors are likely to remain indolent and which tumor will move on to become lethal.
Huang WC, Atoria CL, Bjurlin M, et al. Management of Small Kidney Cancers in the New Millennium: Contemporary Trends and Outcomes in a Population-Based Cohort.JAMA Surg. Published online May 27, 2015. doi:10.1001/jamasurg.2015.0294.
MedicalResearch.com Interview with: Wiliam C. Huang, MD FACSAssociate Professor of Urology, Division of Urologic Oncology, & NYU Langone Medical Center/Perlmutter Cancer Institute (2015). Treatment For Small Kidney Cancers Has Evolved MedicalResearch.com