BACKGROUND: To investigate recurrence rates in patients with T1 renal cell carcinoma (RCC) undergone partial nephrectomy (PN), radiofrequency ablation (RFA) or cryoablation (Cryo).METHODS: We retrospectively evaluated data from 665 (81.4%), 68 (8.3%) and 83 (10.3%) patients who underwent PN, RFA and Cryo, respectively. Kaplan-Meier curves depict recurrence-free survival (RFS) rates in the overall population and after stratifying according to tumor's histology (namely, clear cell RCC and non-clear RCC) and size (namely < 2 cm and 2-4 cm). Multivariable Cox regression model was used to identify predictors of recurrence. Cumulative-incidence plots evaluated disease recurrence and other causes of mortality (OCM).RESULTS: Patients referred to PN experienced higher RFS rate compared to those treated with RFA and Cryo at 60-month in the overall population (96.4% vs. 79.4 % vs. 87.8%), in patients with clear cell RCC (93.3% vs 75% vs. 80.4%) and in those with tumor of 2-4 cm (97.3% vs 78% and 84.4%; all p≤0.01). In patients with non-clear cell RCC and with tumor <2cm, PN showed higher RFS rate at 60-month as compared to RFA (97.9% vs 84.4% and 95.1% vs 78.1%, respectively; all p≤0.02). At multi-variate analysis, ablative techniques (RFA [HR=4.03] and Cryo [HR=3.86]) were independent predictors of recurrence (all p<0.03). At competing risks analysis, recurrence rate and OCM were 7.3% and 1.3% vs 25% and 7.2% vs 19.9% and 19.9% for PN, RFA and Cryo, respectively.CONCLUSIONS: PN and Cryo showed similar RFS rates in patients with non-clear cell RCC and with renal mass < 2cm.

Bianchi, L., Mineo Bianchi, F., Chessa, F., Barbaresi, U., Casablanca, C., Piazza, P., et al. (2021). Percutaneous tumor ablation versus partial nephrectomy for small renal mass: the impact of histologic variant and tumor size. MINERVA UROLOGICA E NEFROLOGICA, 73(5), 581-590 [10.23736/S2724-6051.20.03983-1].

Percutaneous tumor ablation versus partial nephrectomy for small renal mass: the impact of histologic variant and tumor size

Bianchi, Lorenzo;Chessa, Francesco;Casablanca, Carlo;Piazza, Pietro;Mottaran, Angelo;Droghetti, Matteo;Roveroni, Carlo;Balestrazzi, Eleonora;Bertaccini, Alessandro;Marcelli, Emanuela;Brunocilla, Eugenio;Schiavina, Riccardo
2021

Abstract

BACKGROUND: To investigate recurrence rates in patients with T1 renal cell carcinoma (RCC) undergone partial nephrectomy (PN), radiofrequency ablation (RFA) or cryoablation (Cryo).METHODS: We retrospectively evaluated data from 665 (81.4%), 68 (8.3%) and 83 (10.3%) patients who underwent PN, RFA and Cryo, respectively. Kaplan-Meier curves depict recurrence-free survival (RFS) rates in the overall population and after stratifying according to tumor's histology (namely, clear cell RCC and non-clear RCC) and size (namely < 2 cm and 2-4 cm). Multivariable Cox regression model was used to identify predictors of recurrence. Cumulative-incidence plots evaluated disease recurrence and other causes of mortality (OCM).RESULTS: Patients referred to PN experienced higher RFS rate compared to those treated with RFA and Cryo at 60-month in the overall population (96.4% vs. 79.4 % vs. 87.8%), in patients with clear cell RCC (93.3% vs 75% vs. 80.4%) and in those with tumor of 2-4 cm (97.3% vs 78% and 84.4%; all p≤0.01). In patients with non-clear cell RCC and with tumor <2cm, PN showed higher RFS rate at 60-month as compared to RFA (97.9% vs 84.4% and 95.1% vs 78.1%, respectively; all p≤0.02). At multi-variate analysis, ablative techniques (RFA [HR=4.03] and Cryo [HR=3.86]) were independent predictors of recurrence (all p<0.03). At competing risks analysis, recurrence rate and OCM were 7.3% and 1.3% vs 25% and 7.2% vs 19.9% and 19.9% for PN, RFA and Cryo, respectively.CONCLUSIONS: PN and Cryo showed similar RFS rates in patients with non-clear cell RCC and with renal mass < 2cm.
2021
Bianchi, L., Mineo Bianchi, F., Chessa, F., Barbaresi, U., Casablanca, C., Piazza, P., et al. (2021). Percutaneous tumor ablation versus partial nephrectomy for small renal mass: the impact of histologic variant and tumor size. MINERVA UROLOGICA E NEFROLOGICA, 73(5), 581-590 [10.23736/S2724-6051.20.03983-1].
Bianchi, Lorenzo; Mineo Bianchi, Federico; Chessa, Francesco; Barbaresi, Umberto; Casablanca, Carlo; Piazza, Pietro; Mottaran, Angelo; Droghetti, Matt...espandi
File in questo prodotto:
Eventuali allegati, non sono esposti

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/805480
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? 7
  • Scopus 15
  • ???jsp.display-item.citation.isi??? 15
social impact