Xiaofeng Chang1, Fan Zhang1, Tieshi Liu1, Changwei Ji1, Xiaozhi Zhao1, Rong Yang1, Xiang Yan1, Wei Wang1, Hongqian Guo2. 1. Department of Urology, The Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China. 2. Department of Urology, The Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China. Electronic address: dr.guohongqian@gmail.com.
Abstract
PURPOSE: We compared outcomes in patients treated with radio frequency ablation or partial nephrectomy for clinical cT1b renal cell carcinoma. MATERIALS AND METHODS: We retrospectively reviewed the records of all patients who underwent radio frequency ablation or nephrectomy between February 2006 and December 2010. Radiographic followup with contrast imaging was performed 7 days, 3 and 6 months, and every 6 months thereafter after radio frequency ablation sequentially. The followup protocol for partial nephrectomy was every 6 months in the initial 3 years and annually thereafter. The Kaplan-Meier method was used to generate survival curves, which were compared with the log rank test. Multivariable regression analysis was done to determine predictors of survival. RESULTS: A total of 56 patients who met selection criteria were included in study. Patients in the radio frequency ablation group had relatively higher mean age and a higher mean ASA® score than those in the partial nephrectomy group. Mean tumor diameter was significantly larger in the partial nephrectomy cohort. For radio frequency ablation vs partial nephrectomy 5-year overall, cancer specific and disease-free survival was 85.5% (95% CI 72.2-98.8) vs 96.6% (95% CI 95.9-97.3), 92.6% (95% CI 82.4-98.1) vs 96.6% (95% CI 95.9-97.3) and 81.0% (95% CI 66.2-95.8) vs 89.7% (95% CI 78.5-97.9), respectively. The percent decrease in the glomerular filtration rate was significantly lower in the radio frequency ablation group at early and last followup. CONCLUSIONS: In appropriately selected patients with stage cT1b renal cell carcinoma radio frequency ablation is an effective treatment option that provides 5-year overall, cancer specific and disease-free survival comparable to that of partial nephrectomy as well as better renal function preservation than partial nephrectomy.
PURPOSE: We compared outcomes in patients treated with radio frequency ablation or partial nephrectomy for clinical cT1b renal cell carcinoma. MATERIALS AND METHODS: We retrospectively reviewed the records of all patients who underwent radio frequency ablation or nephrectomy between February 2006 and December 2010. Radiographic followup with contrast imaging was performed 7 days, 3 and 6 months, and every 6 months thereafter after radio frequency ablation sequentially. The followup protocol for partial nephrectomy was every 6 months in the initial 3 years and annually thereafter. The Kaplan-Meier method was used to generate survival curves, which were compared with the log rank test. Multivariable regression analysis was done to determine predictors of survival. RESULTS: A total of 56 patients who met selection criteria were included in study. Patients in the radio frequency ablation group had relatively higher mean age and a higher mean ASA® score than those in the partial nephrectomy group. Mean tumor diameter was significantly larger in the partial nephrectomy cohort. For radio frequency ablation vs partial nephrectomy 5-year overall, cancer specific and disease-free survival was 85.5% (95% CI 72.2-98.8) vs 96.6% (95% CI 95.9-97.3), 92.6% (95% CI 82.4-98.1) vs 96.6% (95% CI 95.9-97.3) and 81.0% (95% CI 66.2-95.8) vs 89.7% (95% CI 78.5-97.9), respectively. The percent decrease in the glomerular filtration rate was significantly lower in the radio frequency ablation group at early and last followup. CONCLUSIONS: In appropriately selected patients with stage cT1b renal cell carcinoma radio frequency ablation is an effective treatment option that provides 5-year overall, cancer specific and disease-free survival comparable to that of partial nephrectomy as well as better renal function preservation than partial nephrectomy.
Authors: Hiten D Patel; Phillip M Pierorazio; Michael H Johnson; Ritu Sharma; Emmanuel Iyoha; Mohamad E Allaf; Eric B Bass; Stephen M Sozio Journal: Clin J Am Soc Nephrol Date: 2017-05-08 Impact factor: 8.237
Authors: Phillip M Pierorazio; Michael H Johnson; Hiten D Patel; Stephen M Sozio; Ritu Sharma; Emmanuel Iyoha; Eric B Bass; Mohamad E Allaf Journal: J Urol Date: 2016-05-06 Impact factor: 7.450
Authors: Johannes Uhlig; Arne Strauss; Gerta Rücker; Ali Seif Amir Hosseini; Joachim Lotz; Lutz Trojan; Hyun S Kim; Annemarie Uhlig Journal: Eur Radiol Date: 2018-09-25 Impact factor: 5.315