Laparoscopic Cryoablation Versus Partial Nephrectomy for the Treatment of Small Renal Masses: Systematic Review and Cumulative Analysis of Observational Studies

2011 ◽  
Vol 60 (3) ◽  
pp. 435-443 ◽  
Author(s):  
Tobias Klatte ◽  
Bernhard Grubmüller ◽  
Matthias Waldert ◽  
Peter Weibl ◽  
Mesut Remzi
Keyword(s):  
Systematic Review ◽  
Partial Nephrectomy ◽  
Observational Studies ◽  
Small Renal Masses ◽  
Renal Masses

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 Ablative Therapies versus Partial Nephrectomy for Small Renal Masses – A systematic review and meta-analysis of observational studies

2021 ◽  
Author(s):  
Vinson Wai-Shun Chan ◽  
Ahmad Abul ◽  
Filzah Osman ◽  
Helen Ng ◽  
Kaiwen Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Complication Rates ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Free Survival ◽  
Oncological Outcomes ◽  
Ablative Therapies ◽  
Lower Complication

Introduction: The ideal treatment of small renal masses is unclear. Ablative therapies (AT) have been considered as a potential alternative to partial nephrectomy (PN) due to their lower complication rates and similar oncological durability. We conducted a systematic review to compare oncological outcomes in T1a or T1b patients undergoing AT vs PN. Methods: This review is registered on PROSPERO (CRD42020199099). Medline, EMBASE, and Cochrane CENTRAL were searched to identify studies comparing AT and PN. The Cochrane RoB 2.0, ROBINS-I tool and the GRADE approach were used to assess any risk of biases. Results: From 1,748 identified records, 32 observational studies and 1 RCT involving 74,946 patients were included. AT patients were found to be significant older than PN patients (MD 5.70, 95% CI 3.83- 7.58), which highlights the serious confounding bias found in the included studies. Patients who received AT for T1a tumours were found to have significantly worse overall survival (HR 1.64, 95% CI 1.39-1.95), but similar cancer-specific survival (CSS), metastatic-free survival, and disease-free survival to PN. There were significantly fewer post-operative complications (RR 0.72, 95%CI 0.55- 0.94) and smaller decline in renal function post-operatively in AT (MD: -7.42, 95%CI -13.1- -1.70). In T1b patients, while CSS was similar between AT and PN, there is contradicting evidence for other oncological outcomes. Conclusion: AT is potentially non-inferior to PN in the treatment of T1a small renal masses due to similar long-term oncological durability, lower complication rates and better renal function preservation. In T1b patients, long-term high-quality studies are needed to confirm potential benefits of AT.

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.

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

V708: Partial Nephrectomy for Small Renal Masses: An Emerging Quality of Care Concern?

2006 ◽  
Vol 175 (4S) ◽  
pp. 229-229
Author(s):  
David C. Miller ◽  
John M. Hollingsworth ◽  
Khaled S. Hafez ◽  
Stephanie Daignault ◽  
Brent K. Hollenbeck
Keyword(s):  
Quality Of Care ◽  
Partial Nephrectomy ◽  
Small Renal Masses ◽  
Renal Masses

Triggers for delayed intervention in patients with small renal masses undergoing active surveillance: a systematic review

2020 ◽  
Vol 72 (4) ◽  
Author(s):  
Riccardo Campi ◽  
Francesco Sessa ◽  
Francesco Corti ◽  
Diego M. Carrion ◽  
Andrea Mari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Active Surveillance ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Delayed Intervention

scholarly journals Oncological outcomes of partial nephrectomy for tumours larger than 4 cm: A systematic review

2014 ◽  
Vol 8 (1-2) ◽  
pp. 61 ◽  
Author(s):  
Tarek H El-Ghazaly ◽  
Ross J Mason ◽  
Ricardo A Rendon
Keyword(s):  
Systematic Review ◽  
Partial Nephrectomy ◽  
Survival Rates ◽  
Cancer Specific Survival ◽  
Renal Masses ◽  
Oncological Outcomes ◽  
Medical Associations ◽  
Nephron Sparing ◽  
Pubmed Search ◽  
Exact Size

Introduction: Many medical associations recommend nephron-sparing surgery (NSS) for tumours larger than 4 cm amenable to partial nephrectomy (PN). These recommendations are, however, mostly based on isolated reports. We systematically review the oncological outcomes of partial nephrectomy procedures performed for tumours larger than 4-cm.Methods: A PubMed search was carried out using keywords “partial nephrectomy” and “nephron sparing” for records dating back to 1995. In total, 2136 abstracts were analyzed; from these, 174 studies were scrutinized. We identified 32 manuscripts reporting size-specific cancer-specific survival rates for masses greater than 4 cm. From each of these studies, we recorded the number of PN, tumour diameter, follow-up duration, 5- and 10-year recurrence, overall and cancer-specific survival rates (OS, CSS). We also calculated weighted OS and CSS rates.Results: This systematic review includes 2445 patients with renal tumours larger than 4 cm who underwent PN: 1858 patients with tumours between 4 to 7 cm, 410 patients with tumours larger than 7 cm and 177 patients with tumours greater than 4 cm (exact size unknown). Our analysis revealed weighted 5-year CSS rates of 95.4%, 86.2% and 93.9% for tumours 4 to 7 cm, >7 cm, and all tumours >4 cm, respectively. The respective 5-year OS rates were 84.7%, 76.4%, and 84.7%.Conclusions: We found excellent 5-year CSS and OS rates for patients with tumours 4 to 7 cm treated with PN. These outcomes compare favourably to those reported in historical radical nephrectomy (RN) series for similarly sized tumours. Thus, PN is an acceptable and often preferred treatment for renal masses >4 cm which are amenable to nephron-sparing procedures.

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