A total of 136 patients were included in the study. Inclusion criteria was normal renal function with a cT1a-b tumor. On univariable analysis, there was no difference in renal function, tumor volume, or R.E.N.A.L. nephrometry score; however, patients who underwent RFA had a lower R.E.N.A.L. score than the PN group (p = 0.04). De novo chronic kidney disease (CKD) did not differ among the three groups (p=0.65). There was no difference in average parenchyma loss between the two partial nephrectomy groups (-27.3 cm3 for non-renorrhaphy PN vs. -23.5 for renorrhaphy PN, p > 0.05). Decrease in RFA treated parenchymal volume (-30.1cm3) was greater than both PN groups (p = 0.03).
The authors concluded that the area of parenchymal injury during RFA may be much larger than the ablative zone. Moreover, both PN techniques were superior to RFA regarding perfused parenchymal volume, but did not relate to de novo CKD III or lower. These findings have implications for patients with imperative indications for nephron-sparing approaches.
Speaker(s): S. Reva, Saint-Petersburg, Russia
Benjamin T. Ristau, MD, SUO Fellow, Fox Chase Cancer Center, Philadelphia, PA
at the #EAU17 - March 24-28, 2017- London, England