Partial nephrectomy versus ablative techniques for small renal masses: a systematic review and network meta-analysis

2018 ◽  
Vol 29 (3) ◽  
pp. 1293-1307 ◽  
Author(s):  
Johannes Uhlig ◽  
Arne Strauss ◽  
Gerta Rücker ◽  
Ali Seif Amir Hosseini ◽  
Joachim Lotz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Partial Nephrectomy ◽  
Meta Analysis ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Ablative Techniques

Ablative therapies versus partial nephrectomy for small renal masses – A systematic review and meta-analysis

2021 ◽  
pp. 106194
Author(s):  
Vinson Wai-Shun Chan ◽  
Ahmad Abul ◽  
Filzah Hanis Osman ◽  
Helen Hoi-Lam Ng ◽  
Kaiwen Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Partial Nephrectomy ◽  
Meta Analysis ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Ablative Therapies

scholarly journals 1637 Ablative Therapies Versus Partial Nephrectomy for Small Renal Masses: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
V W S Chan ◽  
A Abul ◽  
H H L Ng ◽  
F H Osman ◽  
K Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Renal Function ◽  
Propensity Score ◽  
Partial Nephrectomy ◽  
Meta Analysis ◽  
Complication Rates ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Free Survival ◽  
Ablative Therapies

Abstract Introduction The optimal management of small renal masses is unclear. Ablative therapies (AT) have been advocated as a potential alternative due to lower complication rates and non-inferior oncological outcomes. We performed a systematic review to compare AT and partial nephrectomy (PN) in patients with T1aN0M0 renal masses. Method This review is registered on PROSPERO (CRD42020199099). A search was performed on Medline, EMBASE, and Cochrane CENTRAL to identify studies comparing AT and PN. Different modalities and approaches were analysed as subgroups. Outcomes include cancer-specific survival (CSS), overall survival (OS), recurrence-free survival (RFS), metastatic-free survival (MFS), postoperative complications, and change in renal function. Results From 1,351 identified records, 30 studies incorporating 85,837 patients were included for meta-analysis. Patients receiving AT were found to have significantly worse CSS, OS, RFS when compared to patients receiving PN (p < 0.05). Patients undergoing AT have a non-inferior MFS and significantly fewer overall complications (HR: 0.79, 95% CI 0.41-1.51, p = 0.48; RR: 0.71, 95% CI 0.53-0.96, p = 0.03). Patients undergoing AT have a smaller decline in renal function post-operatively (SMD: 0.30, 95% CI 0.11-0.50). When limited to studies with propensity score matching, CSS and RFS are no longer significantly different between the two groups (HR: 1.54, 95% CI 0.67-3.52, p = 0.31, HR: 1.72, 95% CI 0.90-3.28, p = 0.10). Subgroup analyses did not show significant differences between different modalities and approaches of AT in all outcomes. Conclusions AT is potentially non-inferior to PN when managing small renal masses, and more high-quality propensity score-matched studies with long follow-up time are needed to confirm the non-inferiority.

scholarly journals Cryoablation versus Partial Nephrectomy for Clinical Stage T1 Renal Masses: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 10 (5) ◽  
pp. 1226-1236 ◽  
Author(s):  
Wen Deng ◽  
Luyao Chen ◽  
Yibing Wang ◽  
Xiaoqiang Liu ◽  
Gongxian Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Partial Nephrectomy ◽  
Meta Analysis ◽  
Clinical Stage ◽  
Renal Masses ◽  
Stage T1

scholarly journals Cryoablation for Small Renal Masses

2008 ◽  
Vol 2008 ◽  
pp. 1-10 ◽  
Author(s):  
J. L. Dominguez-Escrig ◽  
K. Sahadevan ◽  
P. Johnson
Keyword(s):  
Minimally Invasive ◽  
Partial Nephrectomy ◽  
Imaging Techniques ◽  
Rapid Development ◽  
High Intensity Focused Ultrasound ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Invasive Approach ◽  
Open Partial Nephrectomy ◽  
Ablative Techniques

Advances in imaging techniques (CT and MRI) and widespread use of imaging especially ultrasound scanning have resulted in a dramatic increase in the detection of small renal masses. While open partial nephrectomy is still the reference standard for the management of these small renal masses, its associated morbidity has encouraged clinicians to exploit the advancements in minimally invasive ablative techniques. The last decade has seen the rapid development of laparoscopic partial nephrectomy and novel ablative techniques such as, radiofrequency ablation (RFA), high-intensity focused ultrasound (HIFU), and cryoablation (CA). In particular, CA for small renal masses has gained popularity as it combines nephron-sparing surgery with a minimally invasive approach. Studies with up to 5-year followup have shown an overall and cancer-specific 5-year survival of 82% and 100%, respectively. This manuscript will focus on the principles and clinical applications of cryoablation of small renal masses, with detailed review of relevant literature.

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