NEW YORK (Reuters Health) - Surgical removal of the kidney -- a procedure known as nephrectomy -- improves survival in patients with locally advanced renal cell carcinoma, the most common form of kidney cancer.

Dr. Pierre I. Karakiewicz from University of Montreal and colleagues determined survival rates for 43,143 patients treated with nephrectomy for advanced renal cell carcinoma that had not spread to other sites and a group of similar patients that did not have the surgery.

Death due to cancer was 5.8-fold higher for nonsurgical therapy than for nephrectomy, the team reports.

In a second analysis, where a subset of patients treated without surgery were matched with up to four surgically treated patients, there was still a 5.1-fold higher rate of cancer-specific mortality (death) in the nonsurgical group than in the nephrectomy group.

Overall, 5- and 10-year estimates of cancer-specific survival were 68.6 percent and 57.5 percent, respectively, for the nephrectomy group, compared with just 14.5 percent and 10.6 percent, respectively, for the nonsurgical therapy group.

This study, the investigators conclude, show that nonsurgical therapy is associated with a 44 percent to 57 percent worse survival than nephrectomy.

"Based on these findings, nephrectomy should be considered as the treatment of choice for patients with locally advanced renal cell carcinoma," they conclude.

SOURCE: BJU (British Journal of Urology) International, December 2008.

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