1531 COMPARATIVE EFFECTIVENESS OF PARTIAL NEPHRECTOMY VERSUS ABLATION OF SMALL RENAL MASSES IN A POPULATION BASED COHORT

Abstract

You have accessJournal of UrologyKidney Cancer: Localized1 Apr 20111531 COMPARATIVE EFFECTIVENESS OF PARTIAL NEPHRECTOMY VERSUS ABLATION OF SMALL RENAL MASSES IN A POPULATION BASED COHORT Jared Whitson, Catherine Harris, and Maxwell Meng Jared WhitsonJared Whitson San Francisco, CA More articles by this author , Catherine HarrisCatherine Harris San Francisco, CA More articles by this author , and Maxwell MengMaxwell Meng San Francisco, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1524AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To compare the long-term oncologic outcome of partial nephrectomy and ablation for T1a renal masses in a population based cohort. METHODS We performed an analysis of the Surveillance Epidemiology and End Results (SEER) database of patients with T1a renal cell carcinoma. Univariable and multivariable Cox regression analyses were performed to determine factors associated with DSS. RESULTS A total of 8,923 cases incident cases of RCC were treated with either partial nephrectomy (8,087) or ablation (836) between 1998 and 2007. Mean follow-up was 3.1 years (SD 1.9) in the partial nephrectomy group and 1.9 years (SD 1.7) in the ablation group. 118 (1.3%) patients died during follow-up of which 99 (1.2%) deaths occurred in the partial nephrectomy group and 19 (2.3%) occurred in the ablation group. In multivariable analysis, every decade increase in age (HR 1.9, 95% CI 1.6–2.3, p<0.001), being not married versus married (HR 1.9, 95% CI 1.3–2.9, p=0.001), and a 1 cm increase in tumor size (HR 1.3, 95% CI 1.0–1.5, p=0.02) were associated with worse survival in multivariable analysis. There was no difference in DSS observed between the treatment types in the first 4 years after surgery (p=0.70). In years 4–8 subjects who underwent ablation had worse survival than those who underwent surgery (HR 4.8, 95% CI 1.8–12.3, p=0.002). CONCLUSIONS During the first 4 years after treatment, there is no difference in mortality in patients with T1a RCC treated with partial nephrectomy or ablation. However, after 4 years of follow-up, the absolute increase in risk of death in those treated with ablation is 14% higher than in those treated with partial nephrectomy. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e615 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jared Whitson San Francisco, CA More articles by this author Catherine Harris San Francisco, CA More articles by this author Maxwell Meng San Francisco, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...