The median follow-up for patients still alive at the last follow-up was 8.3 years. The estimated overall survival rates at 10 and 15 years were 69% and 53%, respectively, for RN compared with 80% and 74%, respectively, following PN. Compared with PN-treated patients, patients who underwent RN were 75% more likely to die from any cause and more than four times more likely to develop stage IV chronic kidney disease, after adjusting for covariates, according to findings published online in European Urology. All of these differences between the RN and PN group were significant.
There have been several studies that concluded that patients that have kidney tumors and have only part of their kidney removed (partial nephrectomy) vs. the entire kidney removed (total or radical nephrectomy) have less kidney problems in the future. They patients with nephron sparing surgery (partial) lived longer as well.
Not all patients are candidates for removing only part of the kidney, but most with tumors under 4cm and most with tumors not in the middle of the kidney should have a partial nephrectomy as a consideration.
At Newark Beth Israel, I have been performing robotic partial nephrectomy since 2005. In 2007 I started using intraoperative renal ultrasound to better show the kidney anatomy. In 2012 I started using firefly to help me perform more accurate kidney surgery for suspected kidney cancer.