Oncologic Efficacy of Radio Frequency Ablation for Small Renal Masses: Clear Cell vs Papillary Subtype

Lay, Aaron; Faddegon, Stephen; Olweny, Ephrem O.; Morgan, Monica; Lorber, Gideon; Trimmer, Clayton; Leveillee, Raymond J.; Cadeddu, Jeffrey A.; Gahan, Jeffrey

doi:10.1016/j.juro.2015.03.115

Cited by 36 publications

(14 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We found no statistical difference in oncologic control between the two surgical methods in the chromophobe RCC population. One group concluded that the prognosis of clear cell RCC after LA was worse than that of nonclear cell carcinoma, which is consistent with previous research 46 . In their study, 229 patients were included (181 clear cell RCC and 48 papillary RCC).…”

Section: Discussionsupporting

confidence: 81%

Local ablation vs partial nephrectomy in T1N0M0 renal cell carcinoma: An inverse probability of treatment weighting analysis

Shi

Liu

et al. 2020

Cancer Medicine

View full text Add to dashboard Cite

Objective To compare the survival outcomes of local ablation (LA) and partial nephrectomy (PN) for T1N0M0 renal cell carcinoma (RCC). Method We identified 38,155 T1N0M0 RCC patients treated with PN or LA in 2004‐2016 from the retrospective Surveillance, Epidemiology, and End Results databases. Among them, there were 4656 LA and 33,499 PN. A Cox proportional hazards regression model, cause‐specific Cox regression and Fine and Gray sub‐distribution hazard ratio (sHR) with inverse probability of treatment weighting (IPTW) adjusting was utilized to compare the effects of LA vs PN on all‐, RCC‐, and non‐RCC–caused mortality. Results Within the IPTW analysis, patients who underwent PN experienced a better overall survival (OS) (HR, 1.56; 95% CI, 1.40‐1.74; P < .001) and cancer‐specific survival (CSS) (HR, 2.21; 95% CI, 1.62‐2.98; P < .001) than LA patients. In the subgroup of patients >85 years (HR, 1.14; 95% CI, 0.73‐1.79, P = .577), chromophobe RCC (HR, 1.68; 95% CI, 0.94‐3.00, P = .078), and tumor size <2 cm (HR, 1.21; 95% CI, 0.95‐1.53, P = .126), the OS showed no significant difference between LA and PN. No significant difference in CSS between LA and PN was observed in the subgroup of chromophobe RCC (HR, 0.34; 95% CI, 0.03‐3.97, P = .389), and tumor size <2 cm (HR, 1.83; 95% CI, 0.92‐3.64, P = .084). For patients >85 years (sHR, 0.89; 95% CI, 0.52‐1.27, P = .520) and tumor size <2 cm (sHR, 1.14; 95% CI, 0.94‐1.38, P = .200), the non‐RCC–specific mortality was not significantly different in PN and LA cohorts, however, for the chromophobe RCC, the LA showed a worse non‐RCC mortality than PN (HR, 1.72; 95% CI, 1.06‐2.79, P = .028). Conclusion PN showed a better prognosis than LA in T1N0M0 RCC treatment, but LA and PN showed a comparable OS in elderly patients (>85), small RCC (<2 cm) and chromophobe RCC.

show abstract

Section: Discussionsupporting

confidence: 81%

Local ablation vs partial nephrectomy in T1N0M0 renal cell carcinoma: An inverse probability of treatment weighting analysis

Shi

Liu

et al. 2020

Cancer Medicine

View full text Add to dashboard Cite

show abstract

“…Patients with clear cell RCC have been observed to have higher levels of serum vascular endothelial growth factor which augments vascular leakage of tumor cells [ 19 ]. Recently, PA of clear cell RCCs have been shown to have less favorable outcomes compared to non-clear cell cancers [ 20 ]. Second, achieving negative margins without residual tumor in surgical resection is commonly viewed to be independent of tumor subtype, however, biology of various RCCs may further impact treatment choice and outcomes.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Histologic Subtype and Treatment Modality for T1a Kidney Cancers1

Siev

Renson

Tan

et al. 2020

KCA

View full text Add to dashboard Cite

Introduction: To evaluate overall survival (OS) of T1a kidney cancers stratified by histologic subtype and curative treatment including partial nephrectomy (PN), percutaneous ablation (PA), and radical nephrectomy (RN). Materials and Methods: We queried the National Cancer Data Base (2004-2015) for patients with T1a kidney cancers who were treated surgically. OS was estimated by Kaplan-Meier curves based on histologic subtype and management. Cox proportional regression models were used to determine whether histologic subtypes and management procedure predicted OS. Results: 46,014 T1a kidney cancers met inclusion criteria. Kaplan Meier curves demonstrated differences in OS by treatment for clear cell, papillary, chromophobe, and cystic histologic subtypes (all p < 0.001), but no differences for sarcomatoid (p = 0.110) or collecting duct (p = 0.392) were observed. Adjusted Cox regression showed worse OS for PA than PN among patients with clear cell (

show abstract

“…The outcomes of ablative therapies, however, are likely not solely influenced by size. For example, Lay et al found improved ablation success in papillary RCC types compared to clear cell types, likely due to differing vascularity of the tumor types [35]. Given that many patients do not have a biopsy prior to their ablation, they also assessed CT enhancement, noting that tumors with enhancement greater than 60 Hounsfield units experienced a higher risk of incomplete ablation compared to less-enhancing tumors [36].…”

Section: Oncologic Outcomes Of Ca and Rfamentioning

confidence: 99%

Ablative Therapies for the Treatment of Small Renal Masses: a Review of Different Modalities and Outcomes

2016

View full text Add to dashboard Cite

The widespread utilization of abdominal imaging has led to an increase in incidentally detected small renal masses. Although partial nephrectomy is still considered the gold standard treatment for these masses, there are risks associated with surgical excision, potentially limiting treatment for older patients with multiple comorbidities. A variety of ablative techniques have developed over the past several decades, altering the management of small renal masses. It is likely that improvements in technology will only broaden the applications of ablative therapy. This article provides an update on the various ablative techniques and outcomes.

show abstract

Oncologic Efficacy of Radio Frequency Ablation for Small Renal Masses: Clear Cell vs Papillary Subtype

Cited by 36 publications

References 26 publications

Local ablation vs partial nephrectomy in T1N0M0 renal cell carcinoma: An inverse probability of treatment weighting analysis

Local ablation vs partial nephrectomy in T1N0M0 renal cell carcinoma: An inverse probability of treatment weighting analysis

Prognostic Value of Histologic Subtype and Treatment Modality for T1a Kidney Cancers1

Ablative Therapies for the Treatment of Small Renal Masses: a Review of Different Modalities and Outcomes

Contact Info

Product

Resources

About