Am I a candidate for a partial nephrectomy?
A partial nephrectomy is a surgical procedure that involves removing your kidney tumour and a small amount of normal tissue surrounding your tumour. Your urologist performs this surgery through an open incision or through a laparoscopic approach.
The joint decision between you and your urologist to perform a partial nephrectomy considers several factors and always includes an analysis of the benefits versus the risks to you. These factors include:
- The size and location of the tumour
- The presence of tumours in both kidneys
- Whether you have only one functioning kidney
- Whether you have other diseases (co-morbidities) that affect your kidney function, now or in the future
A partial nephrectomy should be the first surgical option considered for any tumour less than 7 cm. However, larger tumours (between 4 and 7 centimetres) can be a challenge for a partial nephrectomy.
Tumours located in the upper or lower pole of your kidney or are in a peripheral location of your kidney are most suited to removal by partial nephrectomy.
It is important to preserve the function of your kidneys. If you have a medical condition that can threaten your future kidney, a partial nephrectomy may be your best surgical option. Examples of these conditions include diabetes, high blood pressure, kidney stone disease, and chronic kidney disease.
If you had previous abdominal surgery for any reason, it may increase the complexity of a partial nephrectomy to the point it is not a suitable option.
A partial nephrectomy is a more complex surgery than a radical nephrectomy. The surgery is best performed by a surgeon with partial nephrectomy experience. If your urologist is not comfortable with the procedure, ask whether they willing to refer you to another urologist for a second opinion.
If you have tumours present in both of your kidneys (either at the same time or at subsequent times) a partial nephrectomy may be the best surgical option for one, or all your kidney tumours.
Having multiple tumours in the kidneys may indicate a hereditary form of kidney cancer.
If you only have one kidney, a partial nephrectomy must be considered as a surgical option; otherwise, you will need dialysis to perform the function of your kidneys. You should discuss with your urologist other options such as ablation or SBRT.
If your doctor suspects that you may have a genetic tendency for kidney cancer, then you may have another tumour(s) at some time in the future. In these cases, it is best to consider a partial nephrectomy as your surgical option to conserve as much kidney function as possible.