Purpose: To compare outcomes in patients treated with radiofrequency ablation (RFA) and partial nephrectomy (PN) for clinical T1a renal-cell carcinoma (RCC) in a propensity-score matched cohort.
Methods: We conducted a retrospective review of the records of all patients who underwent RFA or nephrectomy between February 2005 and December 2009 in our institution. The Kaplan-Meier method was used to generate the survival curves that were compared with the log-rank test. Univariable and multivariable regression analyses were performed to determine predictors of survival.
Results: A total of 90 patients were included in the final study after being matched by propensity scores (RFA 45; PN 45). The 5-year overall survival (95% confidence interval [CI]) was 90.2% (78.6-98.8) vs 93.2% (85.8-98.9); 5-year cancer-specific survival (95% CI) was 95.6% (89.5-98.1) vs 97.7% (93.4-99.3); 5-year disease-free survival (95% CI) was 86.7% (89.5-96.7) and 88.5% (79.1-97.9); 5-year recurrence-free survival (95% CI) was 95.4% (89.3-98.1) vs 97.7% (93.3-99.2); and 5-year metastasis-free survival (95% CI) was 95.5% (89.4-98.0) vs 95.5% (89.4-98.0). Age was the only factor that could predict the disease-free survival (P=0.044). The percentage decrease in the glomerular filtration rate was significantly lower in the RFA group at the time of last follow-up (P=0.001).
Conclusions: In the propensity-score matched cohort of patients with clinical T1a RCC, we observed that RFA was an effective treatment option that provided comparable 5-year oncologic outcomes and better preservation of renal function than PN.
Written by:
Chang X, Liu T, Zhang F, Ji C, Zhao X, Wang W, Guo H. Are you the author?
Department of Urology, the Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
Reference: J Endourol. 2015 Feb 18. Epub ahead of print.
doi: 10.1089/end.2014.0864
PubMed Abstract
PMID: 25556579