Laparoscopic vs Percutaneous Cryoablation for the Small Renal Mass: 15-Year Experience at a Single Center

Objective To analyze our 15-year experience with small renal masses ablation and present oncologic and functional outcomes of laparoscopic cryoablation (LCA) and percutaneous cryoablation (PCA). Materials and Methods We identified patients who underwent LCA (n = 275) or PCA (n = 137) for small renal...

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Published in:Urology (Ridgewood, N.J.) N.J.), 2015-04, Vol.85 (4), p.850-855
Main Authors: Zargar, Homayoun, Samarasekera, Dinesh, Khalifeh, Ali, Remer, Erick M, O'Malley, Charles, Akca, Oktay, Autorino, Riccardo, Kaouk, Jihad H
Format: Article
Language:English
Subjects:
Adenoma, Oxyphilic - pathology
Adenoma, Oxyphilic - surgery
Aged
Carcinoma, Renal Cell - secondary
Carcinoma, Renal Cell - surgery
Cryosurgery - adverse effects
Cryosurgery - methods
Disease-Free Survival
Female
Glomerular Filtration Rate
Humans
Kidney Neoplasms - pathology
Kidney Neoplasms - surgery
Laparoscopy
Male
Middle Aged
Neoplasm Recurrence, Local - pathology
Neoplasm Recurrence, Local - surgery
Survival Rate
Tumor Burden
Urology
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Summary:Objective To analyze our 15-year experience with small renal masses ablation and present oncologic and functional outcomes of laparoscopic cryoablation (LCA) and percutaneous cryoablation (PCA). Materials and Methods We identified patients who underwent LCA (n = 275) or PCA (n = 137) for small renal masses between 1997 and 2012. Differences in overall survival (OS) and recurrence-free survival (RFS) were analyzed using a log-rank test. Cox proportional hazard ratios model was used to determine factors that predicted OS. Fit proportional hazard risk ratios were also calculated to determine if there were any factors that affected tumor recurrence. Results Tumor sizes were equal between the 2 groups; however, tumors in the PCA group were more complex. The overall (7.27% and 7.29%) and major complications (0.7% and 3.6%) were similar. The estimated probability of 5-year OS for LCA and PCA was 89% and 82%, respectively. The estimated probability of the 5-year RFS for LCA and PCA was 79% and 80%, respectively. Heart disease (hazard ratio, 2.15; 95% confidence interval, 1.35-3.41; P  = .001) and history of disease recurrence (hazard ratio, 2.49; 95% confidence interval, 1.60-3.86; P  = .001; P  
ISSN:0090-4295
1527-9995
DOI:10.1016/j.urology.2015.01.004