Mount Sinai. US: In patients with small renal tumors confined to the kidneys, close,
active monitoring, as opposed to immediate surgery, is associated with
low rates of tumor growth or death, according to a study by a researcher
at the Icahn School of Medicine at Mount Sinai published in the
September issue of the Journal of Urology.
Although surgical excision of tumors remains the standard of care for
renal tumors that have not yet spread (localized), the risk of
complications in elderly or ill patients may outweigh the benefits of
surgery. The study suggests that actively monitoring renal tumors in
some patients may prove a safer option than immediate surgery.
The incidence of kidney cancer in the United States has been
increasing for two decades, with the trend partly attributed to the
introduction of abdominal imaging studies such as CT scans or MRIs in
the 1980’s. However, death rates due to renal cell carcinoma (kidney
cancer) have not decreased, indicating that surgery may be of little or
no benefit to some patients.
“We are beginning to better understand the behavior of tumors that grow on the kidneys,” said Reza Mehrazin, MD,
Assistant Professor, Urology, Icahn School of Medicine at Mount Sinai,
the study’s lead investigator. “In some patients, particularly those who
are considered elderly or ‘high risk,’ we are now more likely able to
delay surgery, sometimes indefinitely.”
In cases which are likely to result in surgery, it is important that
urologists understand the natural history of renal tumors. If surgery
does prove necessary, minimally invasive surgery using robotic tools may
be possible. For example, a robotic partial nephrectomy provides the
surgeon with enhanced visualization and precision during the procedure,
which translates to significantly less blood loss. Moreover, the
incisions are smaller and result in less pain and shorter recovery time
and hospital stay.
“Patients diagnosed with renal tumors have more options than ever
before, said Dr. Mehrazin. “Surgery is not always the best solution. It
is vital that patients consult with their urologists to explore all
options and make the best treatment decision for that particular case.”
About the Mount Sinai Health System
The Mount Sinai Health System is an integrated health system
committed to providing distinguished care, conducting transformative
research, and advancing biomedical education. Structured around seven
member hospital campuses and a single medical school, the Health System
has an extensive ambulatory network and a range of inpatient and
outpatient services—from community‐based facilities to tertiary and
quaternary care.
The System includes approximately 6,600 primary and specialty care
physicians, 12‐minority‐owned free‐standing ambulatory surgery centers,
over 45 ambulatory practices throughout the five boroughs of New York
City, Westchester, and Long Island, as well as 31 affiliated community
health centers. Physicians are affiliated with the Icahn School of
Medicine at Mount Sinai, which is ranked among the top 20 medical
schools both in National Institutes of Health funding and by U.S. News
& World Report.