Radiofrequency ablation versus partial nephrectomy in patients with solitary clinical t1a renal cell carcinoma: Comparable oncologic outcomes at a minimum of 5 years of follow-up

Ephrem O. Olweny, Samuel K. Park, Yung K. Tan, Sara L. Best, Clayton K Trimmer, Jeffrey A Cadeddu

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Abstract

Background: Long-term comparative outcomes for radiofrequency ablation (RFA) versus partial nephrectomy (PN) for the primary treatment of clinical T1a renal cell carcinoma (RCC) have not previously been reported. Objective: Report comparative 5-yr oncologic outcomes for RFA versus PN in patients with clinical T1a RCC. Design, setting, and participants: Observational single-institution cohort study, involving consecutive patients with a solitary histologically confirmed T1a RCC treated by RFA or PN and followed for a minimum of 5 yr. Those presenting with synchronous multiple, metachronous, bilateral, and/or metastatic disease, a history of hereditary RCC syndromes, a family history of RCC, and with post-treatment follow-up <5 yr were excluded from analysis. Measurements: The Kaplan-Meier method was used to determine 5-yr overall survival (OS), cancer-specific survival (CSS), local recurrence-free survival (local RFS), overall disease-free survival (DFS), and metastasis-free survival (MFS) for RFA versus PN. Survival curves were compared using the log-rank test. A p value ≤0.05 was considered statistically significant. Results and limitations: A total of 37 patients in each group met the selection criteria. The RFA cohort was significantly older and had more advanced comorbidities, but other patient characteristics were similar. For RFA versus PN, median follow-up was 6.5 yr (interquartile range [IQR]: 5.8-7.1) versus 6.1 yr (IQR: 5.4-7.3) (p = 0.68), respectively. The 5-yr OS was 97.2% versus 100% (p = 0.31), CSS was 97.2% versus 100% (p = 0.31), DFS was 89.2% versus 89.2% (p = 0.78), local RFS was 91.7% versus 94.6% (p = 0.96), and MFS was 97.2% versus 91.8% (p = 0.35), respectively. Study limitations are retrospective data analysis, loss to follow-up, limited statistical power, and limited generalizability of our data. Conclusions: In appropriately selected patients, RFA is an effective minimally invasive therapy for the treatment of cT1a RCC, yielding comparable long-term oncologic outcomes to nephron-sparing surgery.

Original languageEnglish (US)
Pages (from-to)1156-1161
Number of pages6
JournalEuropean Urology
Volume61
Issue number6
DOIs
StatePublished - Jun 2012

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Nephrectomy
Renal Cell Carcinoma
Survival
Disease-Free Survival
Neoplasm Metastasis
Recurrence
Nephrons
Therapeutics
Patient Selection
Comorbidity
Neoplasms
Cohort Studies
Retrospective Studies

Keywords

  • Ablation techniques
  • Carcinoma
  • renal cell
  • Treatment outcome

ASJC Scopus subject areas

  • Urology

Cite this

Radiofrequency ablation versus partial nephrectomy in patients with solitary clinical t1a renal cell carcinoma : Comparable oncologic outcomes at a minimum of 5 years of follow-up. / Olweny, Ephrem O.; Park, Samuel K.; Tan, Yung K.; Best, Sara L.; Trimmer, Clayton K; Cadeddu, Jeffrey A.

In: European Urology, Vol. 61, No. 6, 06.2012, p. 1156-1161.

Research output: Contribution to journalArticle

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title = "Radiofrequency ablation versus partial nephrectomy in patients with solitary clinical t1a renal cell carcinoma: Comparable oncologic outcomes at a minimum of 5 years of follow-up",
abstract = "Background: Long-term comparative outcomes for radiofrequency ablation (RFA) versus partial nephrectomy (PN) for the primary treatment of clinical T1a renal cell carcinoma (RCC) have not previously been reported. Objective: Report comparative 5-yr oncologic outcomes for RFA versus PN in patients with clinical T1a RCC. Design, setting, and participants: Observational single-institution cohort study, involving consecutive patients with a solitary histologically confirmed T1a RCC treated by RFA or PN and followed for a minimum of 5 yr. Those presenting with synchronous multiple, metachronous, bilateral, and/or metastatic disease, a history of hereditary RCC syndromes, a family history of RCC, and with post-treatment follow-up <5 yr were excluded from analysis. Measurements: The Kaplan-Meier method was used to determine 5-yr overall survival (OS), cancer-specific survival (CSS), local recurrence-free survival (local RFS), overall disease-free survival (DFS), and metastasis-free survival (MFS) for RFA versus PN. Survival curves were compared using the log-rank test. A p value ≤0.05 was considered statistically significant. Results and limitations: A total of 37 patients in each group met the selection criteria. The RFA cohort was significantly older and had more advanced comorbidities, but other patient characteristics were similar. For RFA versus PN, median follow-up was 6.5 yr (interquartile range [IQR]: 5.8-7.1) versus 6.1 yr (IQR: 5.4-7.3) (p = 0.68), respectively. The 5-yr OS was 97.2{\%} versus 100{\%} (p = 0.31), CSS was 97.2{\%} versus 100{\%} (p = 0.31), DFS was 89.2{\%} versus 89.2{\%} (p = 0.78), local RFS was 91.7{\%} versus 94.6{\%} (p = 0.96), and MFS was 97.2{\%} versus 91.8{\%} (p = 0.35), respectively. Study limitations are retrospective data analysis, loss to follow-up, limited statistical power, and limited generalizability of our data. Conclusions: In appropriately selected patients, RFA is an effective minimally invasive therapy for the treatment of cT1a RCC, yielding comparable long-term oncologic outcomes to nephron-sparing surgery.",
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T1 - Radiofrequency ablation versus partial nephrectomy in patients with solitary clinical t1a renal cell carcinoma

T2 - Comparable oncologic outcomes at a minimum of 5 years of follow-up

AU - Olweny, Ephrem O.

AU - Park, Samuel K.

AU - Tan, Yung K.

AU - Best, Sara L.

AU - Trimmer, Clayton K

AU - Cadeddu, Jeffrey A

PY - 2012/6

Y1 - 2012/6

N2 - Background: Long-term comparative outcomes for radiofrequency ablation (RFA) versus partial nephrectomy (PN) for the primary treatment of clinical T1a renal cell carcinoma (RCC) have not previously been reported. Objective: Report comparative 5-yr oncologic outcomes for RFA versus PN in patients with clinical T1a RCC. Design, setting, and participants: Observational single-institution cohort study, involving consecutive patients with a solitary histologically confirmed T1a RCC treated by RFA or PN and followed for a minimum of 5 yr. Those presenting with synchronous multiple, metachronous, bilateral, and/or metastatic disease, a history of hereditary RCC syndromes, a family history of RCC, and with post-treatment follow-up <5 yr were excluded from analysis. Measurements: The Kaplan-Meier method was used to determine 5-yr overall survival (OS), cancer-specific survival (CSS), local recurrence-free survival (local RFS), overall disease-free survival (DFS), and metastasis-free survival (MFS) for RFA versus PN. Survival curves were compared using the log-rank test. A p value ≤0.05 was considered statistically significant. Results and limitations: A total of 37 patients in each group met the selection criteria. The RFA cohort was significantly older and had more advanced comorbidities, but other patient characteristics were similar. For RFA versus PN, median follow-up was 6.5 yr (interquartile range [IQR]: 5.8-7.1) versus 6.1 yr (IQR: 5.4-7.3) (p = 0.68), respectively. The 5-yr OS was 97.2% versus 100% (p = 0.31), CSS was 97.2% versus 100% (p = 0.31), DFS was 89.2% versus 89.2% (p = 0.78), local RFS was 91.7% versus 94.6% (p = 0.96), and MFS was 97.2% versus 91.8% (p = 0.35), respectively. Study limitations are retrospective data analysis, loss to follow-up, limited statistical power, and limited generalizability of our data. Conclusions: In appropriately selected patients, RFA is an effective minimally invasive therapy for the treatment of cT1a RCC, yielding comparable long-term oncologic outcomes to nephron-sparing surgery.

AB - Background: Long-term comparative outcomes for radiofrequency ablation (RFA) versus partial nephrectomy (PN) for the primary treatment of clinical T1a renal cell carcinoma (RCC) have not previously been reported. Objective: Report comparative 5-yr oncologic outcomes for RFA versus PN in patients with clinical T1a RCC. Design, setting, and participants: Observational single-institution cohort study, involving consecutive patients with a solitary histologically confirmed T1a RCC treated by RFA or PN and followed for a minimum of 5 yr. Those presenting with synchronous multiple, metachronous, bilateral, and/or metastatic disease, a history of hereditary RCC syndromes, a family history of RCC, and with post-treatment follow-up <5 yr were excluded from analysis. Measurements: The Kaplan-Meier method was used to determine 5-yr overall survival (OS), cancer-specific survival (CSS), local recurrence-free survival (local RFS), overall disease-free survival (DFS), and metastasis-free survival (MFS) for RFA versus PN. Survival curves were compared using the log-rank test. A p value ≤0.05 was considered statistically significant. Results and limitations: A total of 37 patients in each group met the selection criteria. The RFA cohort was significantly older and had more advanced comorbidities, but other patient characteristics were similar. For RFA versus PN, median follow-up was 6.5 yr (interquartile range [IQR]: 5.8-7.1) versus 6.1 yr (IQR: 5.4-7.3) (p = 0.68), respectively. The 5-yr OS was 97.2% versus 100% (p = 0.31), CSS was 97.2% versus 100% (p = 0.31), DFS was 89.2% versus 89.2% (p = 0.78), local RFS was 91.7% versus 94.6% (p = 0.96), and MFS was 97.2% versus 91.8% (p = 0.35), respectively. Study limitations are retrospective data analysis, loss to follow-up, limited statistical power, and limited generalizability of our data. Conclusions: In appropriately selected patients, RFA is an effective minimally invasive therapy for the treatment of cT1a RCC, yielding comparable long-term oncologic outcomes to nephron-sparing surgery.

KW - Ablation techniques

KW - Carcinoma

KW - renal cell

KW - Treatment outcome

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