The objective of this study was to investigate renal function after robot-assisted partial nephrectomy (RAPN) and percutaneous cryoablation (PCA) in clinical stage T1 (cT1) renal cell carcinoma (RCC) and evaluate the relationship between baseline renal function and renal functional outcome.
Patients with cT1 RCC treated with RAPN or PCA were prospectively enrolled between June 2019 and January 2021. Renal function was evaluated using estimated glomerular filtration rate, Tc-99m diethylenetriamine-pentaacetate plasma clearance, Tc-99m mercaptoacetyltriglycine renography, and renal volume at baseline and 6 months after treatment.
Fifty-six patients were included (18 RAPN, 38 PCA). PCA patients had a significantly higher age (68.5 years; P = 0.019) and Charlson comorbidity index (3.0; P = 0.007). Tumor characteristics did not differ significantly between RAPN and PCA. Total renal volume decreased significantly after PCA (-18.2 cm3; P = 0.001). Baseline chronic disease stage IIIb-IV leads to a greater reduction in renal volume (-31.8 cm3; P = 0.003) but not other renal function measures. Renal function declined significantly after either treatment without significant differences between RAPN and PCA.
This study found a small, similar decrease in renal function 6 months after RAPN or PCA, despite significant differences in baseline patient characteristics. Reduced renal function at baseline did not lead to a worse renal functional outcome.
Journal of clinical imaging science. 2023 Dec 15*** epublish ***
Louise Aarup Duus, Theresa Junker, Benjamin Schnack Brandt Rasmussen, Mie Holm Vilstrup, Lars Lund, Michael Pedersen, Ole Graumann
Department of Radiology, Odense University Hospital, Odense, Denmark., Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark., Department of Urology, Odense University Hospital, Odense, Denmark., Department of Comparative Medicine Lab, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark., UNIFY, Research- and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark.