Ablation therapy versus partial nephrectomy for small renal masses
Treating small renal masses with ablation therapy achieves similar outcomes but is accompanied by substantially fewer complications compared to partial nephrectomy.
A new meta-analysis in Academic Radiology reviews the outcomes of patients who have undergone either partial nephrectomy or ablation therapy for small renal masses, comparing operation times, hospital stays and complication rates. The team’s findings portray both treatment options in a similar light when it comes to overall survival rates, but partial nephrectomy creates significantly more burden for both patients and hospital resources.
“Due to the good survival outcome of [small renal masses] it is essential to preserve renal function to the maximum extent. As a result, researchers are increasingly focusing on less invasive ablation,” corresponding author Yunxiang Li, MD, from the Department of Urology at Nanchong Central Hospital in China, and colleagues note.
Ablation therapy includes radiofrequency ablation, cryoablation and microwave ablation. Previous studies have shown that each method can serve as a viable alternative to other surgical options, though those studies varied in methodology and did not specify whether percutaneous or laparoscopic approaches were used.
This most recent work builds on prior research, taking into account multiple ablation therapy methods. It includes 27 studies and more than 6,000 patient cases.
According to the data, on average, nephrectomy surgeries take over an hour longer than ablations. Patients who have nephrectomy also have longer hospital stays (nearly three days), more blood loss (median 97.76 ml) and higher complication rates.
There are no significant differences, however, between rates of overall, cancer-specific or recurrence-free survival between the two options.
“Our study provides evidence for the use of ablation in small mass renal tumors,” the group writes. “However, there are many questions that need to be addressed by future studies.”
These questions, which relate to which patients would benefit the most from ablation, the economic benefits and how to address the higher recurrence rates associated with ablation therapies (a finding of this and numerous other studies), should be the focus of future studies, the group suggests.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.