Partial nephrectomy versus ablative therapy for the treatment of renal tumors in an imperative setting

Abstract

In imperative indication of nephron-sparing treatment for a kidney tumor, either PN or AT can be proposed. PN offers the ability to manage larger and more complex tumors while providing a better local control and a similar renal function loss.

Synchronous bilateral renal cell carcinomas with differing histologies

“…9 Partial nephrectomy may facilitate the management of large, complex tumors, while ablation therapy may be suitable for small, well-marginated tumors. 10 The best possible prediction of expected histologies from preoperative diagnostic imaging is also important. Robot-assisted partial nephrectomy was thus performed for the left renal tumor first in the present case, because of its larger, 42-mm diameter compared to the 26-mm right tumor.…”

Peri‐operative and local control outcomes of robot‐assisted partial nephrectomy vs percutaneous cryoablation for renal masses: comparison after matching on radiological stage and renal score

“…Tanagho et al showed that CA was associated with an increased recurrence risk compared with RAPN in an unmatched analysis (HR 11.4; P = 0.01). Long et al observed that 5‐year radiological recurrence‐free survival favoured PN compared with ablative therapies (92% vs 74%; log‐rank P < 0.001). Caputo et al compared oncological outcomes in patients with cT1b disease after 1:1 matching for main oncological characteristics.…”

“…While matching is necessary to improve methodological bias, only a prospective randomized trial would definitively determine whether CA is able to treat small renal tumours as well as PN in terms of recurrence‐free survival. Moreover, although surgery might provide improved local control, most studies failed to demonstrate any difference in terms of specific survival .…”

Percutaneous ablation techniques for renal cell carcinoma: current status and future trends

“…However, in the past couple of years, literature has been laden with substantiated intermediate and long-term follow-up data; reviews and series, mainly from retrospective observational studies in which thermal ablation, mainly RFA and CA, is compared to surgery still considered gold-standard [12,24,52,58,[65][66][67][68]. In addition, percutaneous thermal based techniques are compared to surgery (nephrectomy, partial nephrectomy), to laparoscopy and among themselves [27,[69][70][71][72][73][74][75][76]. The most recent European Society of Medical Oncology (ESMO) guidelines suggest that percutaneous ablation techniques (incl.…”