June 21, 2019
There are multiple options for the treatment of renal masses, including surveillance, surgery and percutaneous treatment. Partial nephrectomy remains the preferred treatment modality for small renal masses, and current guidelines consider percutaneous ablation an option for small renal masses ― mainly to be considered for those patients not amenable to or unfit for surgery.
Clinical guidelines also highlight a deficiency in the literature comparing partial nephrectomy and percutaneous ablation. As a result, the need for high-quality data with long-term follow-up is prioritized.
Identifying the appropriate treatment options for each patient
R. Houston Thompson, M.D., with Urology at Mayo Clinic in Rochester, Minnesota, and a research team performed a review of a large cohort of patients to compare long-term oncologic outcomes with partial nephrectomy, percutaneous radiofrequency ablation and percutaneous cryoablation in the treatment of localized kidney masses. Study results were published online in European Urology in 2019.
In total, over 1,400 patients with renal masses were reviewed. These patients were treated with:
- Partial nephrectomy (1,055 patients)
- Percutaneous radiofrequency ablation (180 patients)
- Percutaneous cryoablation (187 patients)
On average, the patients were followed for five to 10 years in each group.
The team found no clinical or statistical difference in five-year local recurrence-free survival, five-year metastasis-free survival, and five-year cancer-specific survival among patients with small masses (< 4 cm).
For patients with slightly larger masses (4 to 7 cm), no clinical or statistical difference in five-year local recurrence-free survival and five-year metastasis-free survival was found.
There was a clinically significant difference in five-year cancer-specific survival; however, this outcome was not statistically different.
Impact on patient care
Ultimately, this work has expanded the treatment options for patients with kidney cancer at various stages. At Mayo Clinic, these data are being used to offer patients a multidisciplinary approach to the management of this disease, to determine which approach is best for each patient and to optimize outcomes.
For more information
Andrews JR, et al. Oncologic outcomes following partial nephrectomy and percutaneous ablation for cT1 renal masses. European Urology. In press.