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Oncologic outcomes following partial nephrectomy and percutaneous ablation for cT1 renal masses

European Urology Jul 14, 2019

Andrews JR, et al. - A total of 1,798 subjects with primary cT1N0M0 renal masses treated between 2000 and 2011 at Mayo Clinic were recognized by the experts in order to update the experience with partial nephrectomy (PN), percutaneous radiofrequency ablation (RFA), and percutaneous cryoablation for cT1 renal masses. Among 1,422 cT1a subjects, 1,055, 180, and 187 underwent PN, RFA, and cryoablation, respectively. Five-year cancer-specific survival for PN, RFA, and cryoablation was observed as 99%, 96%, and 100%, respectively. Out of 376 cT1b patients with a median clinical follow-up of 8.7 and 6.0 years, 324 and 52 underwent PN and cryoablation, respectively. Hence, percutaneous ablation seemed to have acceptable results for cT1 renal tumors and was suitable for patients with a contraindication for surgery. Clinically important variations among PN and ablation were unlikely for cT1a patients and, therefore, treatment choice should include shared decision making. For cT1b patients, death from renal cell carcinoma was more common with cryoablation, and huge variations in this outcome could not be ruled out. Moreover, in order to verify the oncologic effectiveness of cryoablation in the cT1b setting, more researches are required.
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