Intermediate comparison of partial nephrectomy and radiofrequency ablation for clinical T1a renal tumours

Stern, Joshua M.; Svatek, Robert S.; Park, Sangtae; Hermann, Michael; Lotan, Yair; Sagalowsky, Arthur I.; Cadeddu, Jeffrey A.

doi:10.1111/j.1464-410x.2007.06937.x

Cited by 129 publications

(67 citation statements)

References 18 publications

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“…The established ablative method for renal cell carcinomas (RCCs) is RFA, which shows comparable oncologic outcomes to partial nephrectomy with more preservation of nephron function (6)(7)(8). CA seems to offer the advantages of minimally invasive surgery with a significantly lower late complication rate than laparoscopic partial nephrectomy (2.2% vs. 16.3%, respectively) (9).…”

mentioning

confidence: 99%

Meta-analysis of cryoablation versus microwave ablation for small renal masses: is there a difference in outcome?

Martin¹,

Athreya²

2013

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to compare local and metastatic recurrence of small renal masses primarily treated by cryoablation or microwave ablation. MATERIALS AND METHODSThe MEDLINE, CINAHL, and PUBMED databases were searched to review the treatment of small renal masses with cryoablation or microwave ablation. Fifty-one studies met the inclusion criteria. RESULTSFifty-one studies representing 3950 kidney lesions were analyzed. No differences were detected in the mean patient age (P = 0.150) or duration of follow-up (P = 0.070). The mean tumor size was significantly larger in the microwave ablation group compared with the cryoablation group (P = 0.030). There was no difference between microwave ablation and cryoablation groups in terms of primary effectiveness (93.75% vs. 91.27%, respectively; P = 0.400), cancer-specific survival (98.27% vs. 96.8%, respectively; P = 0.470), local tumor progression (4.07% vs. 2.53%, respectively; P = 0.460), or progression to metastatic disease (0.8% vs. 0%, respectively; P = 0.120). Patient age was predictive of overall complications in the multivariate analysis (P = 0.020). Local tumor progression with cryoablation was predicted by the mean follow-up duration using univariate (P = 0.009) and multivariate regression (P = 0.003). Clear cell and angiomyolipoma were more frequent in the microwave ablation group (P < 0.0001 and P = 0.03328, respectively), and papillary, chromophobe, and oncocytoma were more frequent in the cryoablation group (P < 0.0001, P < 0.0001, and P = 0.0004, respectively). Open access was used more often in the microwave ablation group than in the cryoablation group (12.20% vs. 1.04%, respectively; P < 0.0001), and percutaneous access was used more frequently in the cryoablation group than in the microwave ablation group (88.64% vs. 37.20%, respectively; P = 0.0021). CONCLUSIONThere is no difference in local or metastatic recurrence between cryoablation-and microwave ablation-treated small renal masses.

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confidence: 99%

Meta-analysis of cryoablation versus microwave ablation for small renal masses: is there a difference in outcome?

Martin¹,

Athreya²

2013

Diagn Interv Radiol

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“…Stern et al published in their study disease-specific survival following RFA in T1a lesions of 93.4 % with a mean followup of 30 months. This was the same outcome for tumours of the same stage treated with partial nephrectomy [37]. In a large study of 243 procedures with a mean follow-up of 27 months, Tracey et al [38] observed a 90 % 5-year recurrence-free survival in histologically proven renal cell cancer.…”

Section: Oncological Outcome Of Rfamentioning

confidence: 55%

Non-Surgical Ablative Therapy for Management of Small Renal Masses—Current Status and Future Trends

Farrag

Sriprasad

2016

Indian J Surg Oncol

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A large number of small renal masses (SRMs) with size less than 4 cm are being identified due to advances in diagnostic imaging. As the natural history of these tumours remains unknown, there is no reliable way to predict their behaviour or future growth. Although, partial nephrectomy is the gold standard for treatment of these tumours, ablative non-surgical therapies such as cryoablation and radiofrequency ablation provide a less invasive option of treatment with comparable oncological outcomes. In this systematic review, the principle, indications, methods of treatment, oncological control, complication and renal function of ablative therapies are critically reviewed. Cryotherapy utilizes the principle of inducing tissue destruction by freezing and thawing using argon and helium gasses, respectively. Radiofrequency ablation (RFA) works on the principle of tissue heating. Ablative treatments are particularly useful in the elderly patients, those with comorbidities or in patients with SRMs in solitary kidneys or renal impairment. Ablative therapies have less procedurerelated complications and have promising medium-term oncological outcome. Longer-term results are accumulating. Cryotherapy may be a better modality for oncological control than RFA. Ablative therapy has emerged as a viable treatment options for SRMs with recurrence free survival rates approaching that of extirpative surgery. However, there is no consensus in the literature on the best selection criteria and this needs further refinement. Prospective long-term data with regards to oncological control is still needed

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“…There were 8 (8%) complications none of which resulted in long-term morbidity. Stern reported with a mean follow up of 30 months that RFA had the same outcome as partial nephrectomy for T1a lesions with a disease specific survival of 93.4% [32]. Levinson described over a period of at least 40 months a recurrence free survival of 90.3% in patients undergoing RFA for SRM in a single kidney [33].…”

Section: Resultsmentioning

confidence: 99%

The Management of Small Renal Tumours by Ablative Therapies

Sriprasad¹,

Marsh²

2011

Current Cancer Treatment - Novel Beyond Conventional Approaches

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Intermediate comparison of partial nephrectomy and radiofrequency ablation for clinical T1a renal tumours

Cited by 129 publications

References 18 publications

Meta-analysis of cryoablation versus microwave ablation for small renal masses: is there a difference in outcome?

Meta-analysis of cryoablation versus microwave ablation for small renal masses: is there a difference in outcome?

Non-Surgical Ablative Therapy for Management of Small Renal Masses—Current Status and Future Trends

The Management of Small Renal Tumours by Ablative Therapies

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