AUA 2019: Comparison of Perioperative and Oncologic Outcomes between Cryoablation and Partial Nephrectomy for Small Renal masses: A Propensity-Score Matching Analysis

Chicago, IL ( Dr. Lorenzo Bianchi introduces the study by outlining an alternate treatment, Cryoablation (CA), to partial nephrectomy (PN) in small renal mass (SRM). The standard treatment for patients diagnosed with SRM is a PN. However, Dr. Bianchi emphasizes that there is roughly a 20% risk of complication. To this end, outcomes were measured for patients treated with PN and compared to patients treated with CA.

Patients were propensity score matched one to one under the categories of age, ASA score, tumor size, and PADUA score. There were no statistically significant overall differences between the two cohorts. Dr. Bianchi highlights that complication rates post-treatment had a p-value of 0.3, which were acceptable. There were significant p-values in both creatine variation and local recurrence, with <0.001 and 0.03 respectively. This showed that PN had a worse outcome in renal function at 39 months, which was the median follow-up time. However, CA had a higher local recurrence.

Dr. Bianchi shows that there is a 0.04 p-value on the disease free survival stratified by surgical technique onto a Kaplan-Meier. To this end, PN had a higher disease free survival at all time points and continued to diverge until the cut-off date of 60 months. There was no significant on the cancer specific survival, which means that the PN and CA were comparable.

He concludes by stating that PN had a higher local cancer control, but had a worse renal function. Both PN and CA had a comparable cancer specific survival. Dr. Bianchi emphasizes that this study is important because it challenges doctors to question which treatment is best, especially in older patients.

Presented by: Lorenzo Bianchi, Alma Mater Studiorum, University of Bologna, Bologna, Italy
Co-authors: Francesco Chessa , Federico Mineo Bianchi , Riccardo Schiavina, Bernardino De Concilio, Marco Borghesi, Pietro Piazza, Lorenzo Bianchi, Cristian Vincenzo Pultrone, Fabrizio Sartio, Serena Di Fresco, Marco Guerra, Andrea Angiolini, Carlo Beretta, Umberto Barbaresi, Eugenio Brunocilla, Antonio Celia 

Written by: Joshua Tran, (Department of Urology, University of California-Irvine) at the American Urological Association's 2019 Annual Meeting (AUA 2019), May 3 – 6, 2019 in Chicago, Illinois