Intermediate-term oncologic outcomes of partial nephrectomy vs cryoablation in renal tumors > 3 cm: A propensity score-matched analysis Journal Article
| Authors: | Pickersgill, N. A.; Vetter, J. M.; Mittauer, D. J.; Elson, L.; Palka, J. K.; Barashi, N. S.; Kim, E. H.; Venkatesh, R.; Bhayani, S. B.; Figenshau, R. S. |
| Article Title: | Intermediate-term oncologic outcomes of partial nephrectomy vs cryoablation in renal tumors > 3 cm: A propensity score-matched analysis |
| Abstract: | Purpose: Cryoablation (CA) and partial nephrectomy (PN) are effective nephron-sparing treatments of small renal masses. While guidelines list thermal ablation as an option for tumors < 3 cm, limited data compare PN and CA in larger tumors. We compared intermediate-term oncologic outcomes between PN and CA in renal masses > 3 cm. Materials and Methods: Patients treated with PN or CA for cT1/cT2, N0M0 renal masses > 3 cm between 2006 and 2016 were identified. Propensity score matching was performed in a 1:2 ratio for patients undergoing CA or PN based on age, BMI, Charlson Comorbidity Index, tumor size, and nephrometry score. Disease-free survival (DFS), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival were estimated using Kaplan-Meier analysis. Results: One hundred thirteen and 57 patients underwent PN and CA with a median follow-up of 4.5 and 3.8 years, respectively. CA was associated with significantly lower 5-year DFS compared with PN (75% vs 94%, P < .001). Local recurrence was more common after CA compared with PN (5.3% vs 1.8%). Technical failure occurred with 32% of CA. However, no significant differences were observed in 5-year MFS (100% for CA vs 96% for PN, P = .2) or CSS (100% for CA vs 98% for PN, P = .4). Conclusions: CA is associated with lower DFS but similar MFS and CSS compared with PN in renal masses > 3 cm. CA is a viable option for well-selected patients with comorbidities or high surgical risk, when combined with salvage ablation as indicated. |
| Keywords: | renal cell carcinoma; partial nephrectomy; cryoablation; management; solitary kidney; masses; laparoscopic cryoablation; cancer |
| Journal Title: | Journal of Urology |
| Volume: | 214 |
| Issue: | 1 |
| ISSN: | 0022-5347 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2025-07-01 |
| Start Page: | 32 |
| End Page: | 40 |
| Language: | English |
| ACCESSION: | WOS:001511231800001 |
| DOI: | 10.1097/ju.0000000000004524 |
| PROVIDER: | wos |
| PUBMED: | 40073100 |
| Notes: | Article -- Source: Wos |
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