PURPOSE: To compare outcomes in patients treated with radiofrequency ablation (RFA) and partial nephrectomy(PN) for clinical T1b(cT1b) renal cell carcinoma(RCC).
MATERIALS AND METHODS: A retrospective study was conducted to review the records of all patients who underwent RFA or nephrectomy between February 2006 and December 2010. Radiographic follow-up with contrast imaging was performed at seven days, three months, six months, and every six months after RFA sequentially; the follow-up protocol for PN was every six months in the initial 3 years and annually thereafter. The Kaplan-Meier method was used to generate the survival curves which were compared with the log-rank test. Multivariable regression analyses were performed to determine predictors of survival.
RESULTS: A total of 56 patients meeting the selection criteria were included in present study. The patients in the RFA group had a relatively higher mean age and higher mean ASA score than those in the PN group. The mean tumor diameter was significantly larger in the PN cohort. The 5-yr OS (95%CI) was 85.5 %( 72.2-98.8) versus 96.6 %( 95.9-97.3); 5-yr CSS (95%CI) was 92.6 %( 82.4-98.1) versus 96.6 %( 95.9-97.3); 5-yr DFS (95%CI) was 81.0% (66.2-95.8) versus 89.7% (78.5-97.9) for RFA versus PN. The percentage decrease in the GFR was significantly lower in the RFA group both at the time of early follow-up and last follow-up.
CONCLUSIONS: In approximately selected patients with stage cT1b RCC, RFA is an effective treatment option which provides comparable 5-yr OS, 5-yr CSS and 5-yr DFS to PN and better preservation of renal function than PN.
Written by:
Chang X, Zhang F, Liu T, Ji C, Zhao X, Yang R, Yan X, Wang W, Guo H. Are you the author?
Medical School of Southeast University, Nanjing, China; Department of Urology, The Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University.
Reference: J Urol. 2014 Aug 5. pii: S0022-5347(14)04152-4.
doi: 10.1016/j.juro.2014.07.112
PubMed Abstract
PMID: 25106899