1:27 PM, Abstract No. 269 - Safety and efficacy of renal cryoablation for small renal masses: midterm follow-up

Abstract

database, all patients with stage T1aN0M0 RCC (r4cm) diagnosed in 2004 to 2011 were identified. Sociodemographic trends in use of surgery vs. TA were evaluated by chi-square and logistic regression. Overall survival (OS) was estimated using Kaplan-Meier from the time of diagnosis. Difference in utilization rate of TA in 2004-2007 vs. 2008-2011 was observed. Results: Of 28351 patients with T1a lesion, 2133 (7.5%) did not receive curative therapy. Of 26218 patients who received curative therapy, the majority underwent surgical resection: 24992 (95.3%) surgical resection, 671(2.6%) CRA, 553(2.1%) (po0.001). While mean overall survival was similar between the surgery (81.1 months) and TA (81.0 months) group (p1⁄40.612). Those who did not receive curative therapy had a significantly shorter mean OS (70.4 mo; po0.001) when compared to curative group as a whole. Furthermore, mean OS for TA group was also significantly prolonged compared to no curative therapy group (po0.001). Being unmarried, Z65 years of age, being insured, living in metropolitan areas, in Pacific Coast region, and residing in areas with higher median family income demonstrated higher likelihoods of receiving TA when compared to surgery (po0.001). There was a significant increase in the rate of use of TA compared to surgery in more recent years (3.2% in 2004-2007 vs. 5.3% in 2008-2011 (po0.001)). Older age, being unmarried, living in rural areas with lower median family income and lower educational status were found to be predictor of not receiving therapy. Conclusion: There was significant disparity in the management of T1a RCC lesions, in part affected by patient’s sociodemographic determinants. In addition, there was significant underutilization of less invasive thermal ablation which demonstrated similar survivorship compared to surgery and significantly prolonged survival compared to no therapy.