Comparison of Radiofrequency Ablation Versus Cryoablation For T1 Renal Tumors: An Evidence-Based Analysis of Comparative Outcomes

Abstract

ObjectiveTo discuss the differences in the effectiveness and security for T1 renal tumors by radiofrequency ablation (RFA) and cryoablation (CA).MethodsWe systematically searched the Cochrane Library, PubMed, Embase, CNKI databases, and Science databases, and the date was from the above database establishment to August 2021. Controlled trials on RFA and CA for T1 renal tumors were included. The meta-analysis was conducted with the Review Manager 5.4 software.ResultsA total of ten studies with 2,367 patients were included in the analysis. There were no significant differences in complications (odds ratio [OR], 1.23; 95% CI, 0.80 to 1.90; p=0.35), primary technique efficacy rate (OR, 1.01; 95% CI, 0.33 to 3.14; p=0.98), changes in serum creatinine (weighted mean difference [WMD], 0.53; 95% CI, -0.50 to 1.57; p=0.31), or 5-year survival rate (hazard ratio [HR], 1.11; 95% CI, 0.41 to 3.00; p=0.84) among patients undergoing RFA and CA. However, compared with patients who underwent RFA, patients who underwent CA had a lower Local recurrence (OR: 2.25; 95% CI: 1.38 to 3.67; p = 0.001).ConclusionThe analysis demonstrated that in the treatment of T1 renal tumors, CA may be associated with lower local recurrence rates. However, no differences were observed in terms of primary technique efficacy rate, 5-year survival rate, changes in serum creatinine, and complication rate between groups.Systematic Review Registration[https://www.crd.york.ac.uk/PROSPERO/], identifier PROSPERO (CRD42021295160).

Management of Renal Cell Carcinoma With Supradiaphragmatic Inferior Vena Cava Thrombus Diagnosed During Acute COVID-19 Infection

“…However, limitations include the risk of tissue charring and challenges in achieving adequate ablation margins, particularly in larger tumors which may require several ablation sessions [ 27 ]. Cryoablation exhibits promising results in the management of renal masses, especially those <3 cm, compared to invasive techniques like partial nephrectomy [ 28 ]. Although some studies discuss the synergy between immunotherapy and ablation techniques [ 29 - 30 ], prospective clinical trials are necessary to substantiate this clinical benefit.…”

Efficacy and safety of cryoablation for localized renal tumor as an alternative approach to partial nephrectomy

“…Second, it included a limited number of patients; mainly because CA is not a treatment supported by a high level of evidence for T1b RCC. Third, it was a non-comparative study, without direct comparison to surgery or to other minimally invasive techniques in interventional radiology, knowing there are some differences between them ( 35 , 36 ). Nevertheless, this work is one of the largest single-centered data gathering on the subject and provides valuable pieces of information to support the use of CA for T1b RCC, consistent with the existing literature.…”

Ablative Treatments for Small Renal Masses and Management of Recurrences: A Comprehensive Review

“…Typical complications following ablation comprise procedural bleeding, perirenal hematoma, temporary hematuria, and visceral injury. Among these, bleeding stands out as the most frequent complication [75].…”