Expert Discusses Balancing the Surgical Risk for Small Kidney Tumors

Some patients with kidney cancer do not need to rush into the operating room, explained Dr. Alexander Kutikov.

For some patients with small renal masses, an active surveillance approach may be more worthwhile than heading straight for surgery, explained Dr. Alexander Kutikov, chief of Urologic Oncology at the Fox Chase Cancer Center in Philadelphia.

At the recent Educated Patient® Kidney Cancer Summit, Kutikov discussed how patients can work with their clinical team to determine if they should start treatment or if a watch-and-wait plan might be better.


We call unnecessary treatment, or treatment for something that doesn't need to be treated, “overtreatment.” And…there's not only just sort of treatment risks, there are the risks like psychosocial consequences, there's financial toxicity, there (are) family disruptions… There are lots of things that a surgery or procedure can have an impact on. But if you talk about surgery, you know, partial nephrectomy or radical nephrectomy, and for these small masses, it's generally always partial nephrectomy. This is, you know, even in the best of hands, at the best centers, the chances of a catastrophe, a mortality, you know, something goes really awry, a peri-operative heart attack or something of that sort. The numbers that are quoted (are) usually two in 1,000 – so .2% And that's not zero; that's a risk that needs to be, again, calibrated and weighed against other options.

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