Percutaneous Image-Guided Cryoablation and Radio-frequency Ablation versus Partial Nephrectomy for small renal cell carcinomas: a ten-years, single-center observational study
BAUS ePoster online library. Chan V. 06/23/21; 319029; p12-10
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Dr. Vinson Wai-shun Chan
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Abstract
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Introduction:
There is a lack of long-term evidence to support the benefit of cryoablation (CRYO) and radio-frequency ablation (RFA) compared to partial nephrectomy (PN) when managing small renal cell carcinomas (RCCs). This study aims to provide long-term evidence for the management of small RCCs using image-guided CRYO or RFA.
Materials and Methods:
All patients in a prospective registry (2004-2015) with a solitary, biopsy- or histology-proven T1N0M0 sporadic RCCs had RFA, CRYO or PN were included in this retrospective analysis. The primary outcome is 10-years cancer-specific survival (CSS). Secondary outcomes include overall survival (OS), local recurrence-free survival (LRFS), metastatic-free survival (MFS), complication rates and change in renal function pre-operatively and post-operatively.
Results:
A total of 296 patients (187 males, 109 females) were included. 239 patients (81%) had T1a disease, and 57 (19%) had T1b disease. The median follow-up period is 77.4 [45] months. A total of 104 (35%), 99 (34%) and 93 (31%) of patients had CRYO, RFA and PN, respectively. CRYO and RFA has similar oncological outcomes to PN (Table). Both the rates and severity of complications did not differ between the three groups. Using linear regression model, the predicted renal function reduction is smaller in CRYO (8.3%) and RFA (12.3%) patients when compared to PN patients (p<0.01).
Conclusion:
Our long-term experience found CRYO and RFA have similar oncological durability and better peri-operative outcomes compared to PN in T1a patients; and should be considered as a first-line treatment. More data is needed to evaluate CRYO and RFA for T1b tumours.
There is a lack of long-term evidence to support the benefit of cryoablation (CRYO) and radio-frequency ablation (RFA) compared to partial nephrectomy (PN) when managing small renal cell carcinomas (RCCs). This study aims to provide long-term evidence for the management of small RCCs using image-guided CRYO or RFA.
Materials and Methods:
All patients in a prospective registry (2004-2015) with a solitary, biopsy- or histology-proven T1N0M0 sporadic RCCs had RFA, CRYO or PN were included in this retrospective analysis. The primary outcome is 10-years cancer-specific survival (CSS). Secondary outcomes include overall survival (OS), local recurrence-free survival (LRFS), metastatic-free survival (MFS), complication rates and change in renal function pre-operatively and post-operatively.
Results:
A total of 296 patients (187 males, 109 females) were included. 239 patients (81%) had T1a disease, and 57 (19%) had T1b disease. The median follow-up period is 77.4 [45] months. A total of 104 (35%), 99 (34%) and 93 (31%) of patients had CRYO, RFA and PN, respectively. CRYO and RFA has similar oncological outcomes to PN (Table). Both the rates and severity of complications did not differ between the three groups. Using linear regression model, the predicted renal function reduction is smaller in CRYO (8.3%) and RFA (12.3%) patients when compared to PN patients (p<0.01).
Conclusion:
Our long-term experience found CRYO and RFA have similar oncological durability and better peri-operative outcomes compared to PN in T1a patients; and should be considered as a first-line treatment. More data is needed to evaluate CRYO and RFA for T1b tumours.
Introduction:
There is a lack of long-term evidence to support the benefit of cryoablation (CRYO) and radio-frequency ablation (RFA) compared to partial nephrectomy (PN) when managing small renal cell carcinomas (RCCs). This study aims to provide long-term evidence for the management of small RCCs using image-guided CRYO or RFA.
Materials and Methods:
All patients in a prospective registry (2004-2015) with a solitary, biopsy- or histology-proven T1N0M0 sporadic RCCs had RFA, CRYO or PN were included in this retrospective analysis. The primary outcome is 10-years cancer-specific survival (CSS). Secondary outcomes include overall survival (OS), local recurrence-free survival (LRFS), metastatic-free survival (MFS), complication rates and change in renal function pre-operatively and post-operatively.
Results:
A total of 296 patients (187 males, 109 females) were included. 239 patients (81%) had T1a disease, and 57 (19%) had T1b disease. The median follow-up period is 77.4 [45] months. A total of 104 (35%), 99 (34%) and 93 (31%) of patients had CRYO, RFA and PN, respectively. CRYO and RFA has similar oncological outcomes to PN (Table). Both the rates and severity of complications did not differ between the three groups. Using linear regression model, the predicted renal function reduction is smaller in CRYO (8.3%) and RFA (12.3%) patients when compared to PN patients (p<0.01).
Conclusion:
Our long-term experience found CRYO and RFA have similar oncological durability and better peri-operative outcomes compared to PN in T1a patients; and should be considered as a first-line treatment. More data is needed to evaluate CRYO and RFA for T1b tumours.
There is a lack of long-term evidence to support the benefit of cryoablation (CRYO) and radio-frequency ablation (RFA) compared to partial nephrectomy (PN) when managing small renal cell carcinomas (RCCs). This study aims to provide long-term evidence for the management of small RCCs using image-guided CRYO or RFA.
Materials and Methods:
All patients in a prospective registry (2004-2015) with a solitary, biopsy- or histology-proven T1N0M0 sporadic RCCs had RFA, CRYO or PN were included in this retrospective analysis. The primary outcome is 10-years cancer-specific survival (CSS). Secondary outcomes include overall survival (OS), local recurrence-free survival (LRFS), metastatic-free survival (MFS), complication rates and change in renal function pre-operatively and post-operatively.
Results:
A total of 296 patients (187 males, 109 females) were included. 239 patients (81%) had T1a disease, and 57 (19%) had T1b disease. The median follow-up period is 77.4 [45] months. A total of 104 (35%), 99 (34%) and 93 (31%) of patients had CRYO, RFA and PN, respectively. CRYO and RFA has similar oncological outcomes to PN (Table). Both the rates and severity of complications did not differ between the three groups. Using linear regression model, the predicted renal function reduction is smaller in CRYO (8.3%) and RFA (12.3%) patients when compared to PN patients (p<0.01).
Conclusion:
Our long-term experience found CRYO and RFA have similar oncological durability and better peri-operative outcomes compared to PN in T1a patients; and should be considered as a first-line treatment. More data is needed to evaluate CRYO and RFA for T1b tumours.
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