Who should have a partial nephrectomy?
If you have a kidney tumor, there are many ways to treat it. The best way depends on many personal factors. The best treatment for most kidney tumors is to remove it with an operation. Most people are born with two kidneys and only need one to survive. Recently, however, it has become clear that the more kidney you have left, the longer you live. Data demonstrates that patients undergoing a partial nephrectomy live longer than patients undergoing a radical nephrectomy for the same stage of tumors. This holds true for patients of all ages, tumor sizes and tumor locations. You can live without any kidneys, but you would have to be on dialysis. Usually you would have to go to a dialysis center for a few hours as much as three times a week. People on dialysis also do not live as long as people who are not.
The average age of patients who received a robot-assisted partial nephrectomy at Roswell Park is 59.4 years old. We have operated on patients as from 23 years of age to 88 years old.
Another factor that’s taken into account when considering surgery is a patient’s weight. Usually, doctors look at a calculation called the Body Mass Index, or BMI, that takes both height and weight into account. The range of BMI values for people whose weight is considered average is 18.5-25. If a person’s BMI is lower than this, they’re underweight; if it’s higher, they’re overweight. If the BMI is over 30, they’re considered obese.
Roswell Park patients having this procedure have ranged from average weight to obese.
Medical history is important when considering surgery. Anesthesiologists use the “ASA” score to classify patients prior to surgery based on their medical history. This is an overall estimation of a person’s physical health, based in part on whether or not there is systemic disease (problems with one of the body’s main systems). ASA scores are given in Roman numerals:
ASA I: a normal, healthy patient
ASA II: a patient with mild systemic disease, such as someone with well-controlled high blood pressure
ASA III: someone with severe systemic disease that interferes with their normal functioning
ASA IV: someone whose disease puts them at constant risk: for example, a person with a combination of serious illnesses
Among the patients from Roswell Park who have had robot-assisted partial nephrectomy, most were ASA II.