MP100-01 PARTIAL NEPHRECTOMY VERSUS CRYOABLATION OR RADIOFREQUENCY ABLATION FOR CLINICAL STAGE T1 RENAL MASSES: SYSTEMATIC REVIEW AND META-ANALYSIS OF MORE THAN 3900 PATIENTS

Abstract

You have accessJournal of UrologyKidney Cancer: Ablative Therapy1 Apr 2017MP100-01 PARTIAL NEPHRECTOMY VERSUS CRYOABLATION OR RADIOFREQUENCY ABLATION FOR CLINICAL STAGE T1 RENAL MASSES: SYSTEMATIC REVIEW AND META-ANALYSIS OF MORE THAN 3900 PATIENTS J. Ricardo Rivero, Jose De La Cerda, Hanzhang Wang, Ann M. Farrell, Michael A. Liss, Ronald Rodriguez, and Dharam Kaushik J. Ricardo RiveroJ. Ricardo Rivero More articles by this author , Jose De La CerdaJose De La Cerda More articles by this author , Hanzhang WangHanzhang Wang More articles by this author , Ann M. FarrellAnn M. Farrell More articles by this author , Michael A. LissMichael A. Liss More articles by this author , Ronald RodriguezRonald Rodriguez More articles by this author , and Dharam KaushikDharam Kaushik More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.3108AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Conflicting data exist with regard to the outcomes of ablation procedures when compared with partial nephrectomy (PN) for cT1 renal masses. We compared all-cause mortality (ACM), cancer-specific mortality (CSM), local recurrence (LR), distant metastases (DM), treatment-related complication rates, and post-procedure changes in estimated glomerular filtration rate (eGFR) between PN and ablation therapies. METHODS We performed systematic review of original articles published upto July 2016. We conducted a meta-analysis to evaluate ACM, CSM, LR, DM rates, treatment-related complications and changes in eGFR. Publication bias was assessed using Begg and Egger tests. RESULTS We identified 961 papers, of which 15 fulfilled our inclusion criteria. These 15 studies represented 3974 patients who had undergone an ablative procedure (CA or RFA; n = 1455, 37%) or PN (n = 2519, 63%). ACM and CSM rates were higher for ablation than for PN (HR 2.11 [95% CI 1.54-2.87], p < 0.05; HR 3.84 [95% CI 1.66-8.88], p < 0.05 respectively). No statistically significant difference in LR rate or risk of DM was seen between ablation and PN (HR 1.32 [95% CI 0.79-2.22], p = 0.22 and HR 1.83 [95% CI 0.67-5.01], p = 0.23, respectively). Complication rates were lower for ablation than for PN (13% versus 17.6%, respectively; OR 0.49 [95% CI 0.25-0.94], p < 0.05). The overall difference in reduction of eGFR between the ablation and PN groups was -7.42 mL/min/1.73 m2 (95% CI -12.48, -2.36; p = 0.04). CONCLUSIONS In this up-to-date meta-analysis, ablation, when compared to PN was associated with higher ACM and CSM, but no differences were seen in rates of LR or DM. Ablation was associated with fewer complications and a smaller reduction in eGFR when compared with PN. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1329 Advertisement Copyright & Permissions© 2017MetricsAuthor Information J. Ricardo Rivero More articles by this author Jose De La Cerda More articles by this author Hanzhang Wang More articles by this author Ann M. Farrell More articles by this author Michael A. Liss More articles by this author Ronald Rodriguez More articles by this author Dharam Kaushik More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...