Which kidney surgery is best for me?
One of the first treatment options to consider for your kidney cancer will be surgery, and our kidney team will assess whether you are healthy enough to undergo surgery; if your cancer can be completely removed with surgery; and if so, which surgical approach is best for you. Kidney surgery involves two main procedures:
- Radical nephrectomy which removes the entire affected kidney as well as some surrounding fat
- Partial nephrectomy which removes only the tumor or just the portion of the kidney with the tumor, sparing the remaining healthy kidney tissue
Partial nephrectomy vs. radical nephrectomy
Although a person can live with just one kidney, Roswell Park’s kidney specialists make every effort to save as much of the affected kidney as possible while removing all the cancer, and always aim to perform a partial nephrectomy, if possible. Studies show that partial nephrectomy is comparable to removing the whole kidney in terms of cancer control. And not removing the kidney is better for the patient long term because it helps to maintain kidney function, which is especially important for patients who may experience more loss of renal function over time, such as those with:
- high blood pressure
- tumors in both kidneys
- only one kidney
Patients in general are living longer and preserving kidney function is important for their later years, when kidney function naturally declines. Partial nephrectomy is best for patients with early-stage disease and small tumors (up to 7 cm wide). Tumor location within the kidney is also critical as the surgeon must be able to remove the entire tumor safely.
Kidney-sparing surgery is a complex procedure. It’s easier for the surgeon to simply remove the whole kidney, but saving the kidney is better for the patient.Thomas Schwaab, MD, PhD
This type of operation may be recommended if your kidney cancer is metastatic, which means it has spread to other parts of your body. Cytoreductive nephrectomy removes part or all of the affected kidney in order to remove all of the primary tumor. Although metastatic tumors still remain, cytoreductive nephrectomy can reduce the amount or burden of cancer in the body and may help other treatments work better against the remaining cancer. Cytoreductive nephrectomy may help to prolong life and improve quality of life.
Nephrectomy with IVC thrombectomy
In some cases, kidney cancer grows into the renal vein that drains the kidney and spreads into inferior vena cava, the vein that brings deoxygenated blood back to the heart. In this way, kidney cancer may spread all the way to the heart. Expertise with difficult cases such as this is important. Roswell Park partners with leading cardiac surgeons in order to operate on the heart and the kidney at the same time, reducing the risks of undergoing two separate procedures.
Robotic surgery — Our experience matters
The vast majority of kidney cancer surgeries at Roswell Park are performed by robotic surgery, a minimally-invasive approach in which the surgeon operates through several tiny ''keyhole'' incisions with the assistance of robotic tools. Robotic surgery results in less pain and blood loss and a shorter hospital stay and recovery period. Patients typically get discharged the day after surgery.