Removal of the Kidney May Prolong Survival in Persons with Renal Cell Carcinoma

Removal of the Kidney May Prolong Survival in Persons with Metastatic Renal Cell Carcinoma

Persons with renal cell cancer that has spread beyond the area of the kidney are commonly treated with chemotherapy and/or biologic therapy to relieve the symptoms of disease and prolong survival time. Whether or not the surgical removal of the affected kidney might also be of benefit has been a subject of debate among researchers. Now, it appears that indeed such surgery (along with biologic therapy) may prolong the lives of some persons with this disease, according to a presentation at the May 2000 American Society of Clinical Oncology meeting.

Renal cell cancer is an uncommon cancer that affects the kidney. Specifically, this type of disease is characterized by the presence of cancer cells in the lining of the tubules, the small tubes in the kidney responsible for filtering and removing waste products from the blood. When renal cell cancer spreads beyond the area of the kidney to the main blood vessels, lymph nodes, or other parts of the body, it is referred to as metastatic disease. Persons who have metastatic renal cell cancer often receive chemotherapy and/or a biologic therapy (to help the immune system fight the cancer) to relieve the symptoms of disease and prolong survival time. Some researchers propose that a surgery to remove the diseased kidney, called a nephrectomy, may also afford some survival advantage for persons with this disease.

Researchers from the Southwest Oncology Group assigned 246 persons with metastatic renal cell cancer to receive either A) a biologic therapy called interferon-alfa with no surgery or B) a nephrectomy followed by therapy with interferon-alfa. The dose of interferon-alfa used was modest, 5 million units 3 times per week. After an average of 187 days, 9% of the patients survive. The average survival time of the patients who underwent the nephrectomy was 12 months, compared with 8 months for those who did not have the surgery.

These findings indicate that treatment with both interferon-alfa and a nephrectomy in future research studies (called clinical trials) may lead to improved outcomes for persons with metastatic renal cell cancer. Persons who have this type of disease may wish to talk with their doctor about the risks and benefits of participating in a clinical trial in which surgery, in combination with interferon-alfa or another promising new treatment, is being studied.

( Proceedings of the American Society of Clinical Oncology Thirty-Sixth Annual Meeting, Vol 19, Abstract 3, pp2a, 2000)

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