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European Radiology
Published in: European Radiology 7/2018

01-07-2018 | Oncology

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

Authors: 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

Published in: European Radiology | Issue 7/2018

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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.
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Metadata
Title
RFA versus robotic partial nephrectomy for T1a renal cell carcinoma: a propensity score-matched comparison of mid-term outcome
Authors
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
Publication date
01-07-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 7/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5305-6

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