"Is the Entire Kidney Removed During Kidney Cancer Surgery?"

Whether to Remove the Entire Kidney During Kidney Cancer Surgery

The necessity of removing the entire kidney during kidney cancer surgery primarily depends on the location and size of the tumor.

Impact of Tumor Size

If the tumor is smaller than four centimeters, nephron-sparing surgery (NSS), also known as partial nephrectomy, is generally an option. This involves removing only the tumorous part while preserving the function of the rest of the kidney. NSS effectively eliminates cancerous tissue while retaining as much healthy kidney tissue as possible, thereby maintaining normal kidney function.

Large Tumor Size

When the tumor exceeds four centimeters, even reaching seven centimeters or larger, radical nephrectomy (removal of the entire kidney) may be favored. Larger tumors tend to invade more kidney tissue, making NSS more challenging and increasing the risk of recurrence. However, advancements in modern medical technology have enabled NSS for some patients even with large tumors, depending on the specific condition and tumor location.

Significance of Tumor Location

Tumor location is a crucial factor in determining whether to remove the entire kidney. A centrally located tumor, even if not excessively large, may necessitate radical nephrectomy. This is because central tumors can more easily affect major kidney vessels and urinary tracts, posing a higher risk for NSS and potentially leaving cancerous tissue behind.

Patient's Overall Health Status

Beyond tumor size and location, the patient's overall health is a vital consideration in surgical decision-making. Factors such as the presence of other chronic diseases and the status of renal function play a role. If the patient's contralateral kidney functions well, radical nephrectomy may be preferred to ensure complete removal of cancerous tissue.

Postoperative Quality of Life

Postoperative quality of life is a mutual concern for both doctors and patients. While NSS preserves more kidney function, it can be technically challenging and require longer recovery. Radical nephrectomy, though simpler, leaves the patient reliant on the remaining kidney and necessitates regular renal function monitoring.

The decision to remove the entire kidney in kidney cancer surgery is multifaceted, encompassing tumor size, location, the patient's overall health, and postoperative quality of life. Each patient's case is unique, and physicians tailor the most suitable treatment plan accordingly. If you or a loved one faces kidney cancer treatment decisions, consult a specialized urologist for personalized medical advice.