Primary tumour surgery gives patients time

Surgery to remove a cancerous kidney extends patients' lives even after the cancer has spread to other parts of the body, says a study in the New England Journal of Medicine.

The results showed that once the tumour had spread, patients gained about three extra months of life if they underwent the surgery. The improvement in life expectancy "was significant but not dramatic", say the editors of the journal, who noted that one year after the operation, only 8 per cent of the patients were alive regardless of the treatment they received.

In a study involving 241 volunteers at 80 medical centres, a team from the Loyola University Stritch School of Medicine in Illinois found that patients who had a cancerous kidney removed and received standard treatment with the drug interferon alfa-2b lived an average of 11.1 months.

Patients who did not receive the surgery died after an average of 8.1 months.

Nonetheless, the Illinois team said the combination of surgery and interferon should become the gold standard against which other experimental forms of kidney cancer treatment are compared.

About 31,000 people in the United States are diagnosed with kidney cancer each year, and about 12,000 die annually, says the American Cancer Society.

For years, some doctors have removed the original tumour even though the cancer had spread. This approach is based on the idea that elimination of the primary tumour makes chemotherapy more effective against the cancer cells that remain.

In October, the Lancet published a study of 85 people which also concluded that surgery helped patients live longer, even when their tumours had spread.

The patients who received interferon alone died in an average of seven months. Patients who had surgery as well died in an average of 17 months.

In an editorial in the Journal of Medicine accompanying the new findings, Dr Ian Tannock, of Toronto, said the study, begun in 1989, seemed to support that strategy.

It also was possible that surgery to remove the original tumour would help in advanced cases of breast, lung or colorectal cancer, but those tests needed to be done separately.

- REUTERS

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