RFA versus robotic partial nephrectomy for T1a renal cell carcinoma: a propensity score-matched comparison of mid-term outcome
| Autor: | Hwang Gyun Jeon, Hyun Moo Lee, Min Yong Kang, Byong Chang Jeong, Byung Kwan Park, Seong Il Seo, Seong Soo Jeon, In Hyuck Gong, Hyun Hwan Sung |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Radiofrequency ablation medicine.medical_treatment 030232 urology & nephrology Urology Renal function Kidney Radiography Interventional Nephrectomy law.invention 03 medical and health sciences 0302 clinical medicine Robotic Surgical Procedures Renal cell carcinoma law medicine Humans Radiology Nuclear Medicine and imaging Propensity Score Carcinoma Renal Cell Survival rate Survival analysis Aged medicine.diagnostic_test business.industry Interventional radiology General Medicine Middle Aged medicine.disease Survival Analysis Kidney Neoplasms Treatment Outcome surgical procedures operative 030220 oncology & carcinogenesis Propensity score matching Catheter Ablation Female Radiology Tomography X-Ray Computed business therapeutics Glomerular Filtration Rate |
| Zdroj: | European Radiology. 28:2979-2985 |
| ISSN: | 1432-1084 0938-7994 |
| DOI: | 10.1007/s00330-018-5305-6 |
| Popis: | To compare oncological and functional mid-term outcomes following robotic partial nephrectomy (RPN) and radiofrequency ablation (RFA) for treating T1a renal cell carcinoma (RCC) using propensity score-matching. Between December 2008–April 2016, 63 patients from each treatment group were propensity score-matched for age, sex, American Society of Anesthesiologists score, tumour size, tumour laterality, tumour histology, R.E.N.A.L. nephrometry score and preoperative estimated glomerular filtration rate (eGFR). Post-treatment follow-up periods for RPN and RFA ranged from 1–90 months (median, 24.6) and 1–65 months (21), respectively. Tumour location, percentage of eGFR preservation and 2-year recurrence-free survival rate were compared between groups. Exophytic and endophytic RCC occurred in 73.0 % (46/63) and 27.0 % (17/63) of the RPN group, and 52.4 % (33/63) and 47.6 % (30/63) of the RFA group, respectively (p=0.017). There was 91.7 % preservation of eGFR in the RPN group and 86.8 % in the RFA group (p=0.088). Two-year recurrence-free survival rate was 100 % in the RPN and 95.2 % in the RFA group (p=0.029). RPN provides a higher recurrence-free survival rate than RFA. However, RFA is a better treatment option for an endophytic or recurrent RCC that is difficult to treat with RPN. • RPN provides a higher recurrence-free survival rate than RFA. • Unlike RPN, repeat RFA is easy to perform for recurrent RCC. • Endophytic RCC could be better treated with RFA. |
| Databáze: | OpenAIRE |
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