Full Nephrectomy vs Partial Nephrectomy on a 1.3 cm tumor

wcco9203

Has anyone have any opinions on if having a full Nephrectomy vs a partial lessens the risk of recurrance of a non aggressive 1.3 cm tumor?  Also, have been told that the smaller the size of tumor, the risk of recurrance is even lower.

sblairc

You might not have a choice

With a tumor that small, you might not get a choice. I think a good surgeon would follow protocol to do a partial. Keep your kidney function preserved. 

Allochka

I guess it is much better to

I guess it is much better to have more kidney preserved. You never know what could happen in the future, maybe you'll need that left part of kidney one day

foroughsh

The risk of  reccurance is

The risk of  reccurance is related to tumor size,grade,stage not how they do the surgery.

If the surgeon takes out your tumor with clear margin then it's OK so partial neph is a better choice if possible.

icemantoo

My choice was easy

Wcco,

When I was nephed 14 years ago they were not doing partials. It was either all or nothing. I have never seen statistics on it, but I have noticed on this and other boards that occaionally RCC later appears on whats left of the partial kidney. Sometimes a partial is a no brainer where there is a problem with the other kidney and/or there are other Kidney issues. Obviously larger tumors must be taken in full, but yours is very small. There is no right or wrong answer.  Discuss this with your surgeon and have him explain the pros and cons of each and then make an intellegent decision. A partial is a litlle more difficult as it involnes more cutting so the recovery is the same either way.

 

 

Icemantoo

wcco9203

icemantoo said:

My choice was easy

Wcco,

When I was nephed 14 years ago they were not doing partials. It was either all or nothing. I have never seen statistics on it, but I have noticed on this and other boards that occaionally RCC later appears on whats left of the partial kidney. Sometimes a partial is a no brainer where there is a problem with the other kidney and/or there are other Kidney issues. Obviously larger tumors must be taken in full, but yours is very small. There is no right or wrong answer.  Discuss this with your surgeon and have him explain the pros and cons of each and then make an intellegent decision. A partial is a litlle more difficult as it involnes more cutting so the recovery is the same either way.

 

 

Icemantoo

I guess this is where the 4-5

I guess this is where the 4-5% comes in.

medic1971

keep this in mind

I had two masses in my right kidney.  One was 2.2cm and the other 0.8cm.  I had a robotic partial nephrectomy and got to keep more than 95% of my right kidney.  You want to keep both of your kidneys if at all possible.  Things like high blood pressure and diabetes have more serious consequences when you only have one kidney.  Besides what if something were to happen to that other kidney, like some traumatic event or, what if, this turns out not to be cancer?  You won't know for sure until they can actually look at the tissue under a microscope. 

Here is a video that discusses management of the small renal mass.  This was done by a urologist at MD Anderson.  It's about 30 minutes long, but there is a lot of really good information in this video:

https://www.youtube.com/watch?v=blUI-ZzcViE

 

daisybud

Medic

Thanks that was a great video. Lots of great information! 

Kim

lcsvb

Medic, I agree with Daisybud!

Wcco, sure seems like a candidate for a partial robotic. Watch medic's video as it is a great resource. My tumor was just over 3 cm and in an almost impossible location near the renal artery, but a great surgeon got it with the robot and spared my kidney!

APny

Unless the location requires

Unless the location requires a full nephrectomy, I would definitely want partial. Whether robotic, laproscopic, or open, a partial that spares most of your kidney is always preferable. It's a more complex surgery than yanking the whole kidney so make sure you have an expert in partials. Recurrence is always a risk and according to studies comparing the two procedures there's no significant difference whether it's partial or full.

hardo718

Medic

Thank you for sharing that video, that was awesome!!  A worthwhile 30 minutes.

Donna~

todd121

Partials

I'm quite confident they've got the science to prove that a partial is as effective as a radical at preventing recurrence. They have to do studies to change standards of care, and the standard used to be a radical. They wouldn't be allowed to do a partial unless they've got the data to show the outcomes are as good as a radical.

Given that, a partial is preferred in terms of saving kidney function. On the other hand, not all urologists do partials. It's a trickier surgery. I'd ask about risks, because I have a feeling the risks are slightly higher with a partial. I don't know what precisely the additional risks are. I have a friend that had a partial and his had to be turned into a radical later because of complications with the partial.

I would have probabaly had a partial if I had been eligible. I wasn't. My tumor was located in the center of the kidney and intertwined with all the blood supply enter/leaving the kidney so they couldn't get it out without destroying the kidney.

Best of luck to you,

Todd

APny

It was the second week after

It was the second week after my partial that I stopped using the oxy they gave me. Tylenol did just fine by then so hang in there for just a little longer. I hated taking it too but it allowed me to walk lots and to sleep through the night. If at all possible, don't rush back to work. Give your body a chance to heal. All the best!

Lejune Wcv

Thanks for the encouragement

Thanks for the encouragement .I went to Hershey medical center I am really happy with the treatment I got there. The doctor said my cancer was type one. whatever that means but reassured me he got it all and I should have no problems !

Lejune Wcv

partial nephrectomy

I just had Mine done on may 27 16 still in some pain after a week. I hope it gets better soon I hate taking oxycodone. it makes me tired. Most of the pain is from the one incision used for the robot. I'm not sure if it will get better in time for me to go back to work . I have no bleeding since the surgery.

 

 

Footstomper

Lejune Wcv said:

Thanks for the encouragement

Thanks for the encouragement .I went to Hershey medical center I am really happy with the treatment I got there. The doctor said my cancer was type one. whatever that means but reassured me he got it all and I should have no problems !

Type 1?

Dunno about that but Grade 1 would mean its a tiddler and you caught it early. Thats brilliant! Whip it out and get on with life. You dont get better news.

APny

Yes, if he meant stage 1 then

Yes, if he meant stage 1 then it's the best possible stage to have. But whenever you're not sure what they mean make sure to ask them to explain. Always advocate for yourself and get as much information as you can.

Footstomper

APny said:

Yes, if he meant stage 1 then

Yes, if he meant stage 1 then it's the best possible stage to have. But whenever you're not sure what they mean make sure to ask them to explain. Always advocate for yourself and get as much information as you can.

As far as is possible I never

As far as is possible I never visit the oncologist alone in case I miss, or misinterprate something.

lejune water

grade or type

I really didn't listen too carefully to the grade  or size.  Just that he said it was all gone! I guess this will be my last post I'm really not much of a chatty cathy. Good luck and good health to all. Afterall it is the only thing that really matters.

APny

All the best to you as well.

All the best to you as well. We're here if you need us.