Retrospective Comparison of Laparoscopic Partial Nephrectomy Versus Laparoscopic Renal Cryoablation for Small (&lt;3.5 cm) Cortical Renal Masses

Haramis, G. M.; Graversen, Joseph A.; Mues, Adam C.; Korets, Ruslan; Rosales, Juan Carlos; Okhunov, Zhamshid; Badani, Ketan K.; Gupta, Mantu; Landman, Jaime

doi:10.1089/lap.2011.0246

Cited by 22 publications

(13 citation statements)

References 28 publications

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“…Seventeen articles including 2,320 lesions treated with CRA were identified (►Table 3). 48,[63][64][65][66][67][68][69][70][71][72][73][74][75] Average size was 2.6 cm, and percutaneous (10), laparoscopic (7), and both percutaneous and laparoscopic (1) approaches were included. Overall recurrence rate was 8.1% (189 lesions) with recurrence rates of 6.4 and 12.3% for percutaneous and laparoscopic approaches, respectively.…”

Section: Review Of Contemporary Oncologic Outcomesmentioning

confidence: 99%

“…We identified 15 studies pertaining to PN in the management of RCC in 3,222 lesions with median follow-up of 46.4 months (►Table 4). 37,38,40,48,49,53,54,64,65,67,68,[76][77][78] Average tumor size was 2.51 cm, and 53 local recurrences were reported resulting in recurrence rate of 1.6%. Of the 616 lesions treated with robotic-assisted PN, no local recurrences were reported within the average follow-up of 41.9 months.…”

Section: Review Of Contemporary Oncologic Outcomesmentioning

confidence: 99%

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Systematic Review of Contemporary Evidence for the Management of T1 Renal Cell Carcinoma: What IRs Need to Know for Kidney Cancer Tumor Boards

Cronan

Dariushnia

Bercu

et al. 2019

Semin intervent Radiol

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Renal cell carcinoma is a relatively common malignancy, with 60 to 70 thousand cases a year in the United States alone. Increased utilization of cross-sectional imaging has led to an increase in the number of early renal cell cancers seen by the medical establishment. In addition, certain patient populations have an increased risk of developing kidney cancers which may mandate aggressive screening protocols. This article discusses the epidemiology of renal cell cancers; discusses the current management guidelines from multiple specialty societies; discusses some of the surgical and interventional techniques used in the treatment of such lesions; and provides a review of the literature regarding treatments of early-stage renal cell cancers.

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Section: Review Of Contemporary Oncologic Outcomesmentioning

confidence: 99%

Section: Review Of Contemporary Oncologic Outcomesmentioning

confidence: 99%

Systematic Review of Contemporary Evidence for the Management of T1 Renal Cell Carcinoma: What IRs Need to Know for Kidney Cancer Tumor Boards

Cronan

Dariushnia

Bercu

et al. 2019

Semin intervent Radiol

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“…Continuous Outcomes. A total of 20 studies assessed continuous renal functional outcomes, showing similar changes for PN compared with TA (15,(30)(31)(32)(33)(34)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62) (Table 1). Meta-analyses showed a larger mean increase in creatinine of 0.07 mg/dl (95% CI, 0.00 to 0.15) and a larger mean decrease in eGFR of 1.0 ml/min per 1.73 m 2 (95% CI, 20.2 to 2.1) for PN compared with TA, but neither was statistically significant (Figure 2, Supplemental Figure 1).…”

Section: Pn Versus Tamentioning

confidence: 99%

Renal Functional Outcomes after Surgery, Ablation, and Active Surveillance of Localized Renal Tumors: A Systematic Review and Meta-Analysis

Patel¹,

Pierorazio²,

Johnson³

et al. 2017

CJASN

124

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Renal functional implications varied across management strategies for localized renal masses, with worse postoperative renal function for patients undergoing radical nephrectomy compared with other strategies and similar outcomes for partial nephrectomy and thermal ablation. Further attention is needed to quantify the changes in renal function associated with active surveillance and nephron-sparing approaches for patients with preexisting CKD.

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“…An increase in newly detection of incidental small renal masses has reached to 2%-3.1% per year owing to routine application of multiple imaging modalities 1, 2. Small renal tumors were more likely to originate in patients with elderly age and comorbidities 3. That's why sufficient renal function preservation and fewer complications were also important besides satisfactory oncological outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…However, no study systematically reviewed cryoablation for T1 renal tumors compared with PN. Several studies have compared cryoablation and PN applied to T1 renal masses 2, 3, 8, 10, 13, 14, 16-26, which may provide evidence that cryoablation could be an alternative challenging PN for surgical high-risk patients with T1 renal masses. Along with those series, a systematic review and meta-analysis was carried out to investigate the efficacy and safety of cryoablation for T1 renal masses compared with PN.…”

Section: Introductionmentioning

confidence: 99%

Cryoablation versus Partial Nephrectomy for Clinical Stage T1 Renal Masses: A Systematic Review and Meta-Analysis

et al. 2019

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Introduction : Cryoablation has been considered as the most efficacious ablative alternative to partial nephrectomy (PN) for selected patients. Our objective is to assess the existing evidence relating to the safety and efficacy of cryoablation compared with PN for clinical T1 renal masses. Materials and Methods : A comprehensive search of PMC, EMBASE, and the Cochrane Library was conducted to identify studies containing comparison of cryoablation and PN. By utilizing those included studies, a systematic review and cumulative meta-analyses were performed to assess the safety and efficacy between cryoablation and PN for T1 renal masses. Results : 17 retrospective studies providing available data were included in our study. Significant differences were found about all oncological variables including all-cause death, cancer-specific death, metastasis and local-recurrence (p < 0.001, p = 0.03, p < 0.001, and p < 0.001, respectively) between the PN group and the cryoablation group. The mean difference between two groups for percent estimated glomerular filtration rate decrease and creatinine increase was -4.84 and 0.15 respectively (p < 0.001 and p = 0.006, respectively). The incidences of overall and postoperative complications in the PN group were significantly higher than that in the cryoablation group (p = 0.001 and p < 0.001, respectively), but the result about intraoperative complications didn't show a significant difference between the two groups (p = 0.53). Conclusions : Comparing with PN, cryoablation for clinical T1 renal tumors is associated with poorer oncological outcomes, but the existing disadvantages are accompanied by lower rate of overall and postoperative complications and superior renal functional preservation. For patients with imperative indications for nephron-sparing surgery who can't risk more invasive PN, cryoablation could be an attractive option. Owing to the inherent limitations of eligible studies, conclusions drawn from our meta-analyses should be interpreted cautiously and be confirmed further with well-designed randomized controlled trials with extensive follow-up length.

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Retrospective Comparison of Laparoscopic Partial Nephrectomy Versus Laparoscopic Renal Cryoablation for Small (<3.5 cm) Cortical Renal Masses

Abstract: In the treatment of small renal cortical neoplasms with short-term follow-up, LPN and LCA seem to be equally effective. LCA offers decreased blood loss, shorter operative time, and less morbidity. Longer follow-up is required to establish oncologic efficacy.

Cited by 22 publications

References 28 publications

Systematic Review of Contemporary Evidence for the Management of T1 Renal Cell Carcinoma: What IRs Need to Know for Kidney Cancer Tumor Boards

Systematic Review of Contemporary Evidence for the Management of T1 Renal Cell Carcinoma: What IRs Need to Know for Kidney Cancer Tumor Boards

Renal Functional Outcomes after Surgery, Ablation, and Active Surveillance of Localized Renal Tumors: A Systematic Review and Meta-Analysis

Cryoablation versus Partial Nephrectomy for Clinical Stage T1 Renal Masses: A Systematic Review and Meta-Analysis

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