Kidney cancer control procedures estimated to have similar benefit

Kidney cancer control procedures estimated to have similar benefit

13 Aug 2014

A large study showed that for kidney cancer patients, surgery and less radical, needle-guided procedures offer near equivalent cancer control for small tumors. The results of the study were published in the journal "European Urology".

"If validated, these data suggest that an update to clinical guidelines would be warranted," says the study's lead author, R. Houston Thompson, M.D., a Mayo Clinic urologist.

Dr. Thompson says radical nephrectomy (surgical removal of the entire kidney) has historically been the standard of care for management of kidney cancer; however, partial nephrectomy (surgical removal of tumors from a kidney while sparing healthy tissue) has become increasingly more common because of its nephron-sparing benefits and similar cancer control. (The nephron is the part of the kidney that filters out toxins from the blood.)

"We undertook this study because direct comparisons of outcomes among patients with kidney cancer who have received partial nephrectomy, radiofrequency ablation (tumor destruction using intense heat) and cryoablation (tumor destruction using extreme cold) are lacking, especially from institutions that routinely perform all three of these procedures," Dr. Thompson says.

Researchers studied a total of 1,803 patients.

Two groups, based on tumor size

Among patients with tumors 4 cm or less:

  • 1,057 patients received partial nephrectomy
  • 180 received radiofrequency ablation and
  • 187 received cryoablation.

Recurrence-free survival was similar among the three treatment groups, while metastases-free survival was significantly better for patients who received partial nephrectomy and cryoablation when compared with patients who received radiofrequency ablation.

For the 379 patients with 4 cm tumors, 326 underwent partial nephrectomy and 53 received cryoablation. Lengths of recurrence-free and metastases-free survival were similar between partial nephrectomy and cryoablation.

Comment from the study's lead

"Cryoablation and radiofrequency ablation have traditionally been thought to provide inferior outcomes compared with surgical removal. Our results of near equivalent success, if correct, should encourage further investigation of these treatment modalities among patients with early stage kidney cancer," Dr. Thompson says.


Source: eCancer News

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