Are Stage T1 Renal Masses Better Treated With Cryoablation or Partial Nephrectomy?

Cryoablation of clinical T1 renal tumors is linked with poorer oncologic outcomes than partial nephrectomy, but patients who underwent cryoablation had lower rates of complications and better preservation of renal function, according to a study published in the Journal of Cancer.

“For patients with imperative indications for nephron-sparing surgery who can’t risk more invasive partial nephrectomy, cryoablation could be an attractive option,” the researchers stated.

Researchers undertook a comprehensive search of PMC, EMBASE, and the Cochrane Library to analyze available studies and determine safety and efficacy of partial nephrectomy versus cryoablation for treatment of patients with T1 renal masses.

The database search yielded 17 retros0pective studies for inclusion in the meta-analysis and systemic review. Investigators evaluated the studies and found that partial nephrectomy had better results than cryoablation in measures of oncologic prognosis, such as all-cause death, cancer-specific death, metastasis, and local recurrence. Additionally, they noted a mean difference between two groups for percent estimated glomerular filtration rate decrease of −4.84 and creatinine increase of 0.15.

However, overall complications and complications after the operation were significantly higher among patients who underwent partial nephrectomy. There was no significant different in intraoperative complications between the partial nephrectomy and cryoablation groups.

“Owing to the inherent limitations of eligible studies, conclusions drawn from our meta-analyses should be interpreted cautiously and be confirmed further with well-designed randomized controlled trials with extensive follow-up length,” the authors concluded.

Reference

Deng W, Chen L, Wang Y, et al. Cryoablation versus Partial Nephrectomy for Clinical Stage T1 Renal Masses: A Systematic Review and Meta-Analysis. J Cancer. 2019 Jan 29;10(5):1226-1236. doi: 10.7150/jca.28881. eCollection 2019.