Partial or Radical Nephrectomy for Early-Stage Kidney Cancer?

The incidence of renal cell carcinoma has been on the rise in the U.S. during the past decade, as the ubiquitous use of CT imaging has led to an increase in the appreciation of small renal masses. Meanwhile, urologic practice has increasingly adopted a paradigm of partial nephrectomy for small renal cancers, after observational studies suggested that patients managed with this approach retain renal function and achieve equivalent cancer outcomes compared with those who undergo radical nephrectomy. However, a recent European randomized trial — widely seen as flawed — demonstrated superior survival in patients undergoing radical nephrectomy (Eur Urol 2010; 59:543).

To examine this issue further, investigators used linked data from the Surveill…