Talenfeld AD, et al. - Researchers compared percutaneous ablation (PA), partial nephrectomy (PN), and radical nephrectomy (RN) for T1a renal cell carcinoma (RCC). The study findings suggested that PA could result in oncologic outcomes similar to those of RN, but with less long-term renal insufficiency and markedly fewer periprocedural complications for well-selected older adults with T1a RCC. It was noted that PA might be correlated with slightly shorter RCC-specific survival but fewer periprocedural complications compared with PN.

Methods

• Using inverse probability of treatment-weighted propensity scores, observational cohort analysis was conducted.
• Researchers analyzed population-based SEER (Surveillance, Epidemiology, and End Results) cancer registry data linked to Medicare claims.
• Participants in the study were persons aged 66 years or older who received treatment for T1a RCC between 2006 and 2011.
• PA vs PN and RN was the main intervention.
• RCC-specific and overall survival, 30- and 365-day postintervention complications were the analyzed measurements.

Results

• For overall survival, 4,310 patients were followed for a median of 52 months and for RCC-specific survival, it was 42 months.
• After PA vs PN, the 5-year RCC-specific survival rate was 95% (95% CI, 93% to 98%) vs 98% (CI, 96% to 99%), and after PA vs RN, they were 96% (CI, 94% to 98%) vs 95% (CI, 93% to 96%).
• After PA vs PN, the 5-year overall survival rate was 77% (CI, 74% to 81%) vs 86% (CI, 84% to 88%), and after PA vs RN, it was 74% (CI, 71% to 78%) vs 75% (CI, 73% to 77%).
• It was observed that cumulative rates of renal insufficiency 31 to 365 days after PA, PN, and RN were 11% (CI, 8% to 14%), 9% (CI, 8% to 10%), and 18% (CI, 17% to 20%), respectively.
• Findings revealed that rates of nonurologic complications within 30 days after PA, PN, and RN were 6% (CI, 4% to 9%), 29% (CI, 27% to 30%), and 30% (CI, 28% to 32%), respectively.
• It was noted that 10% of patients in the PN group had intraoperative conversion to RN.
• Data reported that 7% of patients in the PA group received additional PA within 1 year of treatment.