Buenos Aires, Argentina (UroToday.com) Peter Black, Associate Professor from University of British Columbia, discussed utility of ablation for SRMs. Current guidelines recommend ablation for candidates not suitable for surgery. The dilemma results from unknown aggressiveness of tumors and inadequate oncologic treatment. Complications, renal function and quality of life in addition to costs are important when considering ablation versus surgery. With no different in oncologic outcomes despite aggressive treatment with surgery illustrates we are over treating SRMs. There is low quality comparative effectiveness research comparing partial nephrectomy and ablation. However, that research have shown increased complications, comparable local recurrence and metastasis free survival between surgery and ablation. Choice of energy may be relevant (cryotherapy versus thermal) when considering ablative techniques. Preservation of renal function is superior in patients undergoing ablation versus partial nephrectomy. Given minimal complication profile and equivalent oncologic efficacy, ablative therapy is a formidable treatment for SRMs.
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Written By: Stephen B. Williams, M.D., Assistant Professor in Urology, The University of Texas Medical Branch, Galveston, TX. and Ashish Kamat, M.D. Professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.