Laparoscopic Cryoablation for Small Renal Masses: Three-Year Follow-up

Weld, Kyle J.; Figenshau, Robert S.; Venkatesh, Ramakrishna; Bhayani, Sam B.; Ames, Caroline D.; Clayman, Ralph V.; Landman, Jaime

doi:10.1016/j.urology.2006.10.030

Cited by 87 publications

(51 citation statements)

References 9 publications

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“…The signifi cantly low cancer-specifi c survival (CSS) in LCA group is at least in part but signifi cantly due to disease characteristics rather than the surgical procedure in question. At least two other studies on LCA have reported on oncological outcome for up to 5 years including the authors group, with overall survival comparable to other minimally invasive techniques [ 2,3,5 ] .…”

Section: Tumour In Solitary Kidney: Laparoscopic Partial Nephrectomy mentioning

confidence: 72%

“…In fact, in a review of surgical outcomes after RP in high-risk patients, 5-and 10-year cancer-specifi c survival rates were 85 -100% and 57 -91.6%, respectively [ 2 ] . Furthermore, data from Memorial Sloan -Kettering examining the effect of RP and EBRT on distant metastasis rates in patients with high-risk disease, found a lower risk of metastatic progression and prostate cancer-specifi c death than for patients treated with EBRT [ 3 ] .…”

Section: The Role Of Surgery In High-risk Localised Prostate Cancermentioning

confidence: 99%

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Tumour in Solitary Kidney: Laparoscopic Partial Nephrectomy vs Laparoscopic Cryoablation

Kumar

2012

BJU International

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Section: Tumour In Solitary Kidney: Laparoscopic Partial Nephrectomy mentioning

confidence: 72%

Section: The Role Of Surgery In High-risk Localised Prostate Cancermentioning

confidence: 99%

Tumour in Solitary Kidney: Laparoscopic Partial Nephrectomy vs Laparoscopic Cryoablation

Kumar

2012

BJU International

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“…The pooled proportion of clinical efficacy was 89% [95% confidential interval (CI) 0.83 to 0.94) in cryoablation therapy from 20 [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] studies with a total of 457 cases. There was statistical significance regarding heterogeneity (I² value)=70.6%) (p<0.0001)…”

Section: Pooled Resultsmentioning

confidence: 99%

An alternative approach to deal with the absence of clinical trials: a proportional meta-analysis of case series studies

2013

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PURPOSE: Systematic reviews are criticized for frequently offering inconsistent evidences and absence of straightforward recommendations. Their value seems to be depreciated when the conclusions are uncertain. To describe an alternative approach of evaluating case series studies in health care when there is absence of clinical trials. METHODS:We provide illustrations from recent experiences. Proportional meta-analysis was performed on surgical outcomes: (a) case series studies, (b) use of cryoablation or radiofrequency ablation, and (c) patients with small renal cell carcinoma. The statistically significant difference between both interventions studied was defined if their combined 95% confidential interval (CI) did not overlap. RESULTS:As demonstrated by the example, this analysis is an alternative approach to provide some evidence of the intervention´s effects under evaluation and plotting all available case series in the absence of clinical trials for the health field. CONCLUSIONS:Although we are leading to a low level of evidence to determine efficacy, effectiveness and safety of interventions this alternative approach can help surgeons, physicians and health professionals for a provisionally decision in health care along with their clinical expertise and the patient´s wishes and circumstances in the absence of high-quality primary studies. It´s not a replacement for the gold standard randomized clinical trial, but an alternative analysis for clinical research. An alternative approach to deal with the absence of clinical trials.A proportional meta-analysis of case series studies

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“…10,11 The major limitation with the published literature is the short follow-up, with most studies ranging from 6 to 24 months; there are limited published series with mean follow-up exceeding 3 years (Table 2). [12][13][14] A recent meta-analysis found the mean weighted follow-up of the published cryoablation literature to be 18.3 months. 2 This present study demonstrated the low morbidity of renal cryoablation, especially compared to the published complication rates of partial nephrectomy.…”

Section: Discussionmentioning

confidence: 99%

Surgical cryoablation as an option for small renal masses in patients who are not ideal partial nephrectomy candidates: intermediate-term outcomes

Chalasani

Martínez

Lim

et al. 2013

CUAJ

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Objective: There has been increasing interest in surveillance and ablative techniques for small renal masses (SRM), given the increasing number being diagnosed at smaller sizes. Of the currently available ablative techniques, radiofrequency ablation and cryoablation have been the popular ones. We describe our intermediate-term outcomes with using cryoablation for SRM in patients who were not ideal candidates for partial nephrectomy. Recurrence-free survival (RFS) and overall survival (OS) were calculated using Kaplan Meier methodology. Results: The mean age was 56.7 years. The mean tumour size was 2.6 cm (range 1.2-4.0 cm). There were no intraoperative or postoperative complications in the 19 patients. One patient has been lost to follow-up; mean follow up was 41.6 months (range 7-84 months) in the cohort. Recurrence, defined as either increase in size of lesion or enhancement on follow-up imaging, was seen in 4 patients. There was 1 non-cancer specific death, and 1 cancer specific death. Conclusions:The 4-year RFS rate and OS rate were 83.6% and 94.1%, respectively, in patients with SRM who were unsuitable for partial nephrectomy.

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Laparoscopic Cryoablation for Small Renal Masses: Three-Year Follow-up

Cited by 87 publications

References 9 publications

Tumour in Solitary Kidney: Laparoscopic Partial Nephrectomy vs Laparoscopic Cryoablation

Tumour in Solitary Kidney: Laparoscopic Partial Nephrectomy vs Laparoscopic Cryoablation

An alternative approach to deal with the absence of clinical trials: a proportional meta-analysis of case series studies

Surgical cryoablation as an option for small renal masses in patients who are not ideal partial nephrectomy candidates: intermediate-term outcomes

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