RFA versus robotic partial nephrectomy for T1a renal cell carcinoma: a propensity score-matched comparison of mid-term outcome

  • Byung Kwan Park
  • In Hyuck Gong
  • Min Yong Kang
  • Hyun Hwan Sung
  • Hwang Gyun Jeon
  • Byong Chang Jeong
  • Seong Soo Jeon
  • Hyun Moo Lee
  • Seong Il Seo
Oncology
  • 24 Downloads

Abstract

Objective

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.

Methods

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.

Results

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).

Conclusions

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.

Key Points

• 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.

Keywords

Radiofrequency catheter ablation Carcinoma, Renal cell Nephrectomy Treatment outcome Kidney 

Abbreviations

ASA

American Society of Anesthesiology

eGFR

Estimated glomerular filtration rate

R.E.N.A.L.

Radius, Exophytic/Endophytic, Nearness to collecting system, Anterior/Posterior, Location relative to polar lines

RCC

Renal cell carcinoma

RFA

Radiofrequency ablation

RPN

Robotic partial nephrectomy

Notes

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Dr. Kyu-Sung Lee.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

During the preparation of our manuscript we have consulted Keumhee Cho, PhD, an expert in statistics/biometry from the Samsung Medical Center, Biostatistics and Clinical Epidemiology Center.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• Retrospective

• Case-control study

• Performed at one institution

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Byung Kwan Park
    • 1
  • In Hyuck Gong
    • 2
  • Min Yong Kang
    • 2
  • Hyun Hwan Sung
    • 2
  • Hwang Gyun Jeon
    • 2
  • Byong Chang Jeong
    • 2
  • Seong Soo Jeon
    • 2
  • Hyun Moo Lee
    • 2
  • Seong Il Seo
    • 2
  1. 1.Department of Radiology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
  2. 2.Department of Urology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea

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