Percutaneous Microwave Ablation Versus Robot-Assisted Partial Nephrectomy for Stage I Renal Cell Carcinoma: A Propensity-Matched Cohort Study Focusing Upon Long-Term Follow-Up of Oncologic Outcomes.

Autor: Chlorogiannis DD; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. dchlorogiannis@bwh.harvard.edu., Kratiras Z; 3rd Department of Urology, University General Hospital 'ATTIKON,' Medical School, National and Kapodistrian University of Athens, Athens, Greece., Efthymiou E; 2nd Department of Radiology, University General Hospital 'ATTIKON,' Medical School, National and Kapodistrian University of Athens, Athens, Greece., Moulavasilis N; 1st Department of Urology, 'Laiko' General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece., Kelekis N; 2nd Department of Radiology, University General Hospital 'ATTIKON,' Medical School, National and Kapodistrian University of Athens, Athens, Greece., Chrisofos M; 3rd Department of Urology, University General Hospital 'ATTIKON,' Medical School, National and Kapodistrian University of Athens, Athens, Greece., Stravodimos K; 1st Department of Urology, 'Laiko' General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece., Filippiadis DK; 2nd Department of Radiology, University General Hospital 'ATTIKON,' Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Jazyk: angličtina
Zdroj: Cardiovascular and interventional radiology [Cardiovasc Intervent Radiol] 2024 May; Vol. 47 (5), pp. 573-582. Date of Electronic Publication: 2024 Apr 01.
DOI: 10.1007/s00270-024-03695-z
Abstrakt: Purpose: To retrospectively compare long-term oncologic outcomes of percutaneous computed tomography-guided microwave ablation (MWA) and robot-assisted partial nephrectomy (RAPN) for the treatment of stage 1 (T1a and T1b) renal cell carcinoma (RCC) patients.
Materials and Methods: Institutional database research identified all T1 RCC patients who underwent either MWA or RAPN. Models were adjusted with propensity score matching. Kaplan-Meier log-rank test analyses and Cox proportional hazard regression models were used to compare the oncologic outcomes. Patient and tumor characteristics, technical success as well as oncologic outcomes were evaluated and compared between the 2 groups.
Results: After propensity score matching, a total of 71 patients underwent percutaneous MWA (mean age 70 ± 10 years) and 71 underwent RAPN (mean age 60 ± 9 years). At 8-year follow-up, the estimated survival rates for MWA cohort were 98% (95% confidence interval [CI] 95-100%) for overall survival, 97% (95% CI 93-100%) for recurrence-free survival, and 97% (95% CI 93-100%) for metastasis-free survival. The matched cohort that underwent RAPN exhibited survival rates of 100% (95% CI 100-100%) for overall survival, 98% (95% CI 94-100%) for recurrence-free survival, and 98% (95% CI 94-100%) for metastasis-free survival. After performing log-rank testing, these rates were not significantly different (p values of 0.44, 0.67, and 0.67, respectively).
Conclusion: The results of the present study suggest that both MWA and RAPN are equally effective in terms of oncologic outcome for the treatment of T1 RCC.
(© 2024. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).)
Databáze: MEDLINE
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