Percutaneous ablation (PA) is associated with oncologic outcomes that are similar to those of radical nephrectomy (RN) and may be associated with fewer complications than nephron-sparing partial nephrectomy (PN) for patients with stage T1a renal cell carcinoma (RCC), according to a study published online June 25 in the Annals of Internal Medicine.
Adam D. Talenfeld, M.D., from Weill Cornell Medicine in New York City, and colleagues compared PA, PN, and RN outcomes for 4,310 individuals aged 66 years or older who received treatment for T1a RCC between 2006 and 2011.
The researchers found that the five-year RCC-specific survival rate was 95 versus 98 percent after PA versus PN and 96 versus 95 percent after PA versus RN.
The five-year overall survival rate was 77 versus 86 percent after PA versus PN and 74 versus 75 percent after PA versus RN. The cumulative rates of renal insufficiency were 11, 9, and 18 percent at 31 to 365 days after PA, PN, and RN, respectively.
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The rates of nonurologic complications were 6, 29, and 30 percent within 30 days after PA, PN, and RN, respectively.
“For well-selected older adults with T1a RCC, PA may result in oncologic outcomes similar to those of RN, but with less long-term renal insufficiency and markedly fewer periprocedural complications,” the authors write. “Compared with PN, PA may be associated with slightly shorter RCC-specific survival but fewer periprocedural complications.”
Three authors disclosed ties to the Association of University Radiologists GE Radiology Research Academic Fellowship.
