Objective To compare oncological and functional mid-term outcomes following robotic partial nephrectomy (RPN) and radio- frequency ablation (RFA) for treating T1a renal cell carcinoma (RCC) using propensity score-matching. Methods Between December 2008–April 2016, 63 patients from each treatment group were propensity score-matched for age, sex, American Society of Anesthesiologists score, tumour size, tumour laterality, tumour histology, R.E.N.A.L. nephrometry score and preoperative estimated glomerular filtration rate (eGFR). Post-treatment follow-up periods for RPN and RFA ranged from 1–90 months (median, 24.6) and 1–65 months (21), respectively. Tumour location, percentage of eGFR preservation and 2- year recurrence-free survival rate were compared between groups. Results Exophytic and endophytic RCC occurred in 73.0 % (46/63) and 27.0 % (17/63) of the RPN group, and 52.4 % (33/63) and 47.6 % (30/63) of the RFA group, respectively (p=0.017). There was 91.7 % preservation of eGFR in the RPN group and 86.8 % in the RFA group (p=0.088). Two-year recurrence-free survival rate was 100 % in the RPN and 95.2 % in the RFA group (p=0.029). Conclusions RPN provides a higher recurrence-free survival rate than RFA. However, RFA is a better treatment option for an endophytic or recurrent RCC that is difficult to treat with RPN.
European Radiology – Springer Journals
Published: Feb 9, 2018
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