National Trends of Local Ablative Therapy among Young Patients with Small Renal Masses in the United States

To assess national trends in the usage of local ablative therapy for small renal masses (SRMs) in a cohort of young patients. Ablation of SRMs has been shown to offer cancer control with limited follow-up.

Although ablation is considered effective for patients with limited life expectancy, its use among younger patients may be considered controversial.

We used the National Cancer Data Base (NCDB) to identify patients between the ages of 40 to 65 years old diagnosed with small renal masses (SRM's) from 2004-2011. Primary outcome was the use of local ablative therapy. Multivariable logistic regression analysis was used to identify patient and hospital factors associated with ablation therapies in this cohort.

During the study period, we identified 49,441 patients with SRMs of which 2,789 (5. 6%) were treated with ablative therapies. The proportion of patients undergoing ablation gradually rose from 2. 2% in 2004 to 6. 2% in 2011 (p

Use of local ablative therapies is gradually rising, but used in a small fraction of young patients with SRMs. Patients treated at high volume, academic hospitals or insured with Medicaid or Medicare were treated to a greater degree with ablation. These results have important implications about understanding the dissemination of ablation and need for long-term cancer surveillance.

Urology. 2015 Sep 01 [Epub ahead of print]

Jonathan E Kiechle, Robert Abouassaly, Marc C Smaldone, Nilay D Shah, Shan Dong, Edward E Cherullo, Dean Nakamoto, Hui Zhu, Matthew M Cooney, Simon P Kim

University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Urology Institute, Cleveland, Ohio 44106. , University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Urology Institute, Cleveland, Ohio 44106; University Hospitals Case Medical Center, Center for Health Care Quality and Research, Cleveland, Ohio; University Hospitals Case Medical Center, Seidman Cancer Center, Cleveland, Ohio. , Fox Chase Cancer Center, Department of Urology, Philadelphia, PA, 19111. , Mayo Clinic, Division of Health Policy and Research, Rochester, MN, 55905. , University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Urology Institute, Cleveland, Ohio 44106. , University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Urology Institute, Cleveland, Ohio 44106; University Hospitals Case Medical Center, Seidman Cancer Center, Cleveland, Ohio. , University Hospitals Case Medical Center, Seidman Cancer Center, Cleveland, Ohio; University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Department of Radiology, Cleveland, Ohio 44106. , Louis Stokes Veteran's Affairs Medical Center, Cleveland, Ohio 44106; Cleveland Clinic Foundation, Cleveland, Ohio 44195. , University Hospitals Case Medical Center, Seidman Cancer Center, Cleveland, Ohio; University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Department of Medical Oncology, Cleveland, Ohio 44106. , University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Urology Institute, Cleveland, Ohio 44106; University Hospitals Case Medical Center, Center for Health Care Quality and Research, Cleveland, Ohio; University Hospitals Case Medical Center, Seidman Cancer Center, Cleveland, Ohio.  

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