Login to Access Video or Poster Abstract: MP100-01
Sources of Funding: None

Introduction

Conflicting data exist with regard to the outcomes of ablation procedures when compared with partial nephrectomy (PN) for cT1 renal masses. _x000D_ We compared all-cause mortality (ACM), cancer-specific mortality (CSM), local recurrence (LR), distant metastases (DM), treatment-related complication rates, and post-procedure changes in estimated glomerular filtration rate (eGFR) between PN and ablation therapies._x000D_

Methods

We performed systematic review of original articles published upto July 2016. We conducted a meta-analysis to evaluate ACM, CSM, LR, DM rates, treatment-related complications and changes in eGFR. Publication bias was assessed using Begg and Egger tests.

Results

We identified 961 papers, of which 15 fulfilled our inclusion criteria. These 15 studies represented 3974 patients who had undergone an ablative procedure (CA or RFA; n = 1455, 37%) or PN (n = 2519, 63%). ACM and CSM rates were higher for ablation than for PN (HR 2.11 [95% CI 1.54-2.87], p < 0.05; HR 3.84 [95% CI 1.66-8.88], p < 0.05 respectively). No statistically significant difference in LR rate or risk of DM was seen between ablation and PN (HR 1.32 [95% CI 0.79-2.22], p = 0.22 and HR 1.83 [95% CI 0.67-5.01], p = 0.23, respectively). Complication rates were lower for ablation than for PN (13% versus 17.6%, respectively; OR 0.49 [95% CI 0.25-0.94], p < 0.05). The overall difference in reduction of eGFR between the ablation and PN groups was -7.42 mL/min/1.73 m2 (95% CI -12.48, -2.36; p = 0.04).

Conclusions

In this up-to-date meta-analysis, ablation, when compared to PN was associated with higher ACM and CSM, but no differences were seen in rates of LR or DM. Ablation was associated with fewer complications and a smaller reduction in eGFR when compared with PN.

Funding

None