Even Small Tumors Can Be Deadly

Kidney tumors of any size can be aggressive and deadly

(RxWiki News) There is a great deal of controversy about when to treat and when to watch certain cancers. Some doctors have argued that small kidney tumors can just be watched. A new study disputes that theory.

All kidney cancers should be treated – no matter the size.

That’s the conclusion of a large new study presented at the 28th Annual European Association of Urology (EAU) Congress in Milan.

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Researchers, led by Sandra Steffen, MD, of the University of Hanover, evaluated how often small renal cell carcinoma (RCC) tumors measuring less than 1 ½ inches in diameter turned out to be deadly.

The study involved 2,197 patients who underwent surgery to treat kidney cancer between 1990 and 2011 at six facilities throughout Germany.

Contrary to popular belief, the study found that tumor size is not always an accurate indicator of disease state. That is, small tumors can be advanced cancers that have already begun to spread (metastasize) to the lymph nodes or other organs.

For this study, investigators followed patients who were diagnosed with tumors with diameters of less than 2 cm, 2-3 cm and 3-4 cm – all about 1 ½ inches or less. Mean follow-up time was five years.

Here’s what the study uncovered:

  • Five-year survival was 93.3 percent in the less than 2 cm group; 92.1 percent in the 2-3 cm group and 92.8 percent in patients with tumors 3-4 cm.
  • Five years following diagnosis or surgery, 5.8 percent of the patients whose cancer had not begun to spread died from kidney cancer.
  • Death rates among the 75 participants whose disease had metastasized was significantly higher, as is true for all cancers. The absolute risk of metastasis among the group was 3 percent.

The authors said the findings of this study demonstrate that even small tumors can be aggressive. Therefore, all kidney tumors should be treated.

"Lymph node and distant metastases occur even in small RCCs. Our data confirm that small RCCs also have an aggressive potential and should be adequately treated," the authors concluded.

“These results have significant implications since the rate of patients diagnosed with small renal masses is increasing and non-operative surveillance protocols are currently being used in patients with small renal tumour,” the authors wrote.

All research is considered preliminary before it is published in a peer-reviewed journal.

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Review Date: 
March 20, 2013