Every year in the UK over 13,000 people are diagnosed with kidney cancer. Localised renal cell carcinoma, in patients with a normal contralateral kidney, has been historically treated by removal of the entire kidney - a radical nephrectomy. The renal function for these patients is partly compensated for by the remaining kidney, but the degree to which it can compensate may be compromised by the effects from ageing and/or commonly occurring medical conditions. It has become standard for small tumours (<4cm, stage T1a), with normal contralateral kidneys, to undergo nephron sparing approaches - primarily involving partial nephrectomy. However, there is uncertainty over the benefits of partial nephrectomy for intermediate sized tumours (4-7cm, stage T1b) and small complex tumours. There are increased surgical complications and, in some cases, more tissue is excised (reducing preservation of renal function) - all of which makes potential gains over radical nephrectomy less clear. There are no high-quality studies to address this uncertainty.
In PARTIAL, funded by the NIHR HTA Programme, 420 eligible participants will receive either a partial nephrectomy or a radical nephrectomy. The aim is to determine the trade-off between potential benefits, harms and cost between partial nephrectomy and radical nephrectomy for intermediate sized and selected small complex kidney tumours, primarily focusing on renal function and surgical complications over 2 years.
The PARTIAL study is led by Professor Naeem Soomro (Newcastle upon Tyne Hospitals NHS Foundation Trust) and Professor Rakesh Heer (Imperial College London, Newcastle University).
For more information, please see the PARTIAL study website