Comparison of Postoperative Complications and Mortality Between Laparoscopic and Percutaneous Local Tumor Ablation for T1a Renal Cell Carcinoma: a Population-Based Study

To evaluate potential differences in local tumor ablation (LTA) perioperative outcomes between the percutaneous (pLTA) and the laparoscopic (lapLTA) approach.

Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare, we identified all patients diagnosed with T1a RCC who underwent either pLTA or lapLTA between 2000 and 2009.

Overall complications at 30-day and mortality at 90-day were examined for both groups. A multivariable logistic regression model was fitted to evaluate the effect of the approach on perioperative complications. A second model was fitted to test for associations between patient or tumor characteristics and type of LTA approach.

Overall, 516 patients diagnosed with T1a RCC were identified. Of those, 289 (56%) were treated with pLTA and 227 (44%) with lapLTA. LapLTA treated patients were younger (median 76 vs. 78, p

No differences in 30-day overall complications or 90-day mortality rates were detected between lapLTA and pLTA for T1a RCC. pLTA was more frequently used in older and sicker individuals. Further prospective studies comparing both procedures should be undertaken.

Urology. 2015 Oct 26 [Epub ahead of print]

Vincent Trudeau, Alessandro Larcher, Katharina Boehm, Paolo Dell'Oglio, Maxine Sun, Zhe Tian, Alberto Briganti, Shahrokh F Shariat, Claudio Jeldres, Pierre I Karakiewicz

Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Department of Urology, University of Montreal Health Center, Montreal, Canada. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Division of Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy. , Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany. , Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Division of Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy. , Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada. , Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada. , Division of Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy. , Department of Urology, Medical University of Vienna, Vienna, Austria. , Department of Urology, University of Sherbrooke, Sherbrooke, Canada. , Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Department of Urology, University of Montreal Health Center, Montreal, Canada.

PubMed

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