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Kidney Cancer

Statistics

The Mayo Clinic Renal Nephrectomy Registry

Renal cell cancer is the most common form of kidney cancer. Physicians detect about 35,000 new cases of renal cell cancer in the United States each year. Surgery remains the only treatment which can cure localized renal cell cancer.

The Mayo Clinic Renal Nephrectomy Registry contains records of all patients who have undergone surgery for renal cell cancer and other solid masses at Mayo Clinic since 1970. Using information from regular follow-up of patients' long-term outcomes, Mayo personnel continually update the registry of the type of surgery, kidney function, complications, and overall survival. That information helps Mayo Clinic urologists make more confident treatment decisions and better-informed predictions of how a patient may respond to treatment.

Radical nephrectomy (surgical removal of the entire kidney) has been the treatment of choice for patients with a localized one-sided renal cell cancer and a normal opposite kidney. When the renal cell cancer is confined to one kidney, the five-year survival rate following radical nephrectomy is 85 percent or better.

Partial nephrectomy is a kidney-sparing surgery that removes only the cancerous areas of the kidney. Patients may need partial nephrectomies when cancer develops in both kidneys or only one kidney remains functional. In recent years, physicians recommend kidney-sparing surgery to patients whose early stage renal cell cancer is discovered on imaging studies performed for other reasons.

Results for minimally invasive laparoscopic procedures are also included in the tables.

The Mayo Clinic Renal Nephrectomy Registry has been analyzed to address a variety of questions. Some include:

What is the risk of early complications after radical nephrectomy and partial nephrectomy?
How do long-term health and survival compare for patients treated with radical nephrectomy and partial nephrectomy?
What clinical features (such as tumor size or grade) predict long-term outcome?

Mayo Clinic physicians have had the following results of kidney surgeries:

Type of Nephrectomy by Year, (5,047 surgeries)

	1970 - 1979	1980 - 1989	1990 - 1999	2000 - 2004
	N=700	N=1,131	N=1,807	N=1,409

Radical Nephrectomy	650 (92.9)	953 (84.3)	1,285 (71.1)	613 (43.5)
Nephron-sparing Surgery	50 (7.1)	178 (15.7)	519 (28.7)	596 (42.3)
Laparoscopic	0 (0.0)	0 (0.0)	3 (0.2)	200 (14.2)

Early (<30 days) Complications, (5,047 surgeries)

	Radical	Nephron-sparing	Laparoscopic
	N=3,501	N=1,343	N=203

		N (%)

Intraoperative Death	9 (0.3)	0 (0.0)	0 (0.0)
Perioperative Death	27 (0.8)	6 (0.5)	0 (0.0)
Total Deaths within 30 Days	76 (2.2)	12 (0.9)	1 (0.5)

Hemorrhage	54 (1.5)	21 (1.6)	2 (1.0)
Deep Vein Thrombosis	17 (0.5)	4 (0.3)	1 (0.5)
Pulmonary Embolism	33 (0.9)	3 (0.2)	0 (0.0)
Myocardial Infarction	17 (0.5)	7 (0.5)	2 (1.0)
Wound Infection	51 (1.5)	22 (1.6)	2 (1.0)
Abscess	10 (0.3)	8 (0.6)	2 (1.0)
Urine Leak	5 (0.1)	32 (2.4)	4 (2.0)
Sepsis	12 (0.3)	5 (0.4)	0 (0.0)
Acute Renal Failure	60 (1.7)	49 (3.7)	4 (2.0)
Dialysis	25 (0.7)	14 (1.0)	2 (1.0)
Kidney Loss	5 (0.1)	8 (0.6)	0 (0.0)
Additional Surgery	97 (2.8)	67 (5.0)	10 (4.9)
Ileus	126 (3.6)	97 (7.2)	17 (8.4)
Pneumothorax	15 (0.4)	3 (0.2)	0 (0.0)

Transfusion Required
	1,064 (30.4)	269 (20.0)	8 (3.9)

Hospital Stay
Unknown <4 days 4-6 days 7-13 days 14+ days	33 (0.9) 179 (5.1) 1,314 (37.5) 1,687 (48.2) 288 (8.2)	7 (0.5) 194 (14.5) 666 (49.6) 393 (29.3) 83 (6.2)	1 (.05) 161 (79.3) 29 (14.3) 9 (4.4) 3 (1.5)

*Note that a single nephrectomy could have resulted in more than one complication.

Late (30 days - 1 year) Complications*, (5,047 surgeries)

	Radical	Nephron-sparing	Laparoscopic
	N=3,501	N=1,343	N=203

		N (%)

Chronic Renal Insufficiency (creatinine >2)	371 (10.6)	124 (9.2)	17 (8.4)
Proteinuria (protein osmolality ratio >0.12)	678 (19.4)	281 (20.9)	41 (20.2)
Wound Hernia	23 (0.7)	15 (1.1)	5 (2.5)
Chronic Renal Failure	117 (3.3)	44 (3.3)	6 (3.0)
Hemodialysis	87 (2.5)	25 (1.9)	3 (1.5)
Peritoneal Dialysis	6 (0.2)	0 (0.0)	0 (0.0)
Other Unspecified Complication	87 (2.5)	28 (2.1)	3 (1.5)