Functional and oncological outcome of percutaneous cryoablation versus laparoscopic partial nephrectomy for clinical T1 renal tumors: A propensity score-matched analysis

Yanagisawa, Takafumi; Miki, Jun; Shimizu, Kanichiro; Fukuokaya, Wataru; Urabe, Fumihiko; Mori, Keiichiro; Sasaki, Hiroshi; Kimura, Takahiro; Miki, Kenta; Egawa, Shin

doi:10.1016/j.urolonc.2020.09.024

Cited by 16 publications

(31 citation statements)

References 28 publications

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“…Data on OP were reported in 17 studies ( 10 , 11 , 15 , 17 , 18 , 20 , 22 , 24 – 28 , 30 – 32 , 34 , 35 ). Compared with MIPN, patients who underwent FT had significantly lower OP (SMD, −1.20; CI, −1.77 to −0.63; I 2 = 97.6%, P < 0.0001) ( Figure 2A ).…”

Section: Resultsmentioning

confidence: 99%

“…Compared with MIPN, patients receiving FT have smaller average tumor size, relatively uncomplicated anatomical location, multiple renal tumors, endogenous tumors, and other factors ( 52 , 53 ). Among the SRMs patients treated with FT, most of the patients’ R.E.N.A.L nephrectomy scores showed that the complexity of the operation was Low or medium ( 11 , 34 ). In adition, part of the literature included in this meta-analysis uses renal measurement scores to assess the complexity of surgery also confirms the appeal argument ( 11 , 14 , 16 , 23 , 29 – 31 , 34 ).…”

Section: Discussionmentioning

confidence: 99%

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A Systematic Review and Meta-Analysis of Minimally Invasive Partial Nephrectomy Versus Focal Therapy for Small Renal Masses

Dong¹,

Liang²,

Ya³

et al. 2022

Front. Oncol.

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BackgroundMinimally invasive partial nephrectomy (MIPN) and focal therapy (FT) are popular trends for small renal masses (SRMs). However, there is currently no systematic comparison between MIPN and FT of SRMs. Therefore, we systematically study the perioperative, renal functional, and oncologic outcomes of MIPN and FT in SRMs.MethodsWe have searched the Embase, Cochrane Library, and PubMed for articles between MIPN (robot-assisted partial nephrectomy and laparoscopic partial nephrectomy) and FT {radiofrequency ablation (RFA), microwave ablation (MWA), cryoablation (CA), irreversible electroporation, non-thermal [irreversible electroporation (IRE)] ablation, and stereotactic body radiation therapy (SBRT)}. We calculated pooled mean difference (MD), odds ratios (ORs), and 95% confidence intervals (CIs) (CRD42021260787).ResultsA total of 26 articles (n = 4,420) were included in the study. Compared with MIPN, the operating time (OP) of FT had significantly lower (SMD, −1.20; CI, −1.77 to −0.63; I2 = 97.6%, P < 0.0001), estimated blood loss (EBL) of FT had significantly less (SMD, −1.20; CI, −1.77 to −0.63; I2 = 97.6%, P < 0.0001), length of stay (LOS) had shorter (SMD, −0.90; CI, −1.26 to −0.53; I2 = 92.2%, P < 0.0001), and estimated glomerular filtration rate (eGFR) of FT was significantly lower decrease (SMD, −0.90; CI, −1.26 to −0.53; I2 = 92.2%, P < 0.0001). However, FT possessed lower risk in minor complications (Clavien 1–2) (OR, 0.69; CI, 0.45 to 1.07; I2 = 47%, P = 0.023) and overall complications (OR, 0.71; CI, 0.51 to 0.99; I2 = 49.2%, P = 0.008). Finally, there are no obvious difference between FT and MIPN in local recurrence, distant metastasis, and major complications (P > 0.05).ConclusionFT has more advantages in protecting kidney function, reducing bleeding, shortening operating time, and shortening the length of stay. There is no difference in local recurrence, distant metastasis, and major complications. For the minimally invasive era, we need to weigh the advantages and disadvantages of all aspects to make comprehensive choices.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier PROSPERO (CRD42021260787).

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Minimally Invasive Partial Nephrectomy Versus Focal Therapy for Small Renal Masses

Dong¹,

Liang²,

Ya³

et al. 2022

Front. Oncol.

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“…Ablative therapies such as PCA offer alternative treatment options for comorbid patients with cT1 RCC, owing to higher residue or recurrence rate with approximately 10% 1–3 . However, there are no widely accepted standards regarding salvage treatment for residue/recurrence after primary ablation therapy 4 …”

Section: Figmentioning

confidence: 99%

“…PCA was performed by cryoablation system (CryoHit ® ; Galil Medical, Yokneam, Israel) and 17‐gauge cryoneedles (IceRod ® ; Galil Medical) under CT or MRI as we previously reported 3 . TAE using a mixture of absolute ethanol and iodized oil was conducted to improve visualization before all CT‐guided primary PCA as well as salvage PCA 5 .…”

Section: Figmentioning

confidence: 99%

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Residue and recurrence in percutaneous cryoablation for cT1 renal tumor: Clinical utility and feasibility of salvage cryoablation with iodized oil marking

et al. 2022

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Perioperative, functional and oncologic outcomes of percutaneous ablation versus minimally invasive partial nephrectomy for clinical T1 renal tumors: outcomes from a pooled analysis

Li,

Wan,

Chen

et al. 2024

J Robotic Surg

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Functional and oncological outcome of percutaneous cryoablation versus laparoscopic partial nephrectomy for clinical T1 renal tumors: A propensity score-matched analysis

Cited by 16 publications

References 28 publications

A Systematic Review and Meta-Analysis of Minimally Invasive Partial Nephrectomy Versus Focal Therapy for Small Renal Masses

A Systematic Review and Meta-Analysis of Minimally Invasive Partial Nephrectomy Versus Focal Therapy for Small Renal Masses

Residue and recurrence in percutaneous cryoablation for cT1 renal tumor: Clinical utility and feasibility of salvage cryoablation with iodized oil marking

Perioperative, functional and oncologic outcomes of percutaneous ablation versus minimally invasive partial nephrectomy for clinical T1 renal tumors: outcomes from a pooled analysis

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