Table 4.
Advances in ablation
| Authors | Patient population | Tumor stage | Median/mean tumor size | Modality | Recurrence | Survival outcomes | Functional outcomes |
|---|---|---|---|---|---|---|---|
| Psutka et al38 | 185 (all RFA) | T1a 143 T1b, 42 | 3 cm (median) | RFA | Last follow-up: 6 (4.2%) T1a, 6 (14.3%) T1b, p=0.0196 | — | — |
| Takaki et al39 | 60 (21 RFA, 39 RN) | T1b | 4.6 cm (RFA), 5.2 (RN, mean) | RFA | 10-year RFS: 84% (RN) vs 88% (RFA), p=0.99 | 10-year OS: 97% (RN) vs 48% (RFA), p<0.009 10-year CSS: 100% (RN) vs 94% (RFA) |
RFA eGFR: 63.2 (baseline), 56.8 (last follow-up, p=0.08) RN eGFR: 88.4 (baseline), 59.6 (last follow-up, p<0.001) |
| Ma et al40, | 58 (all RFA) | T1a | 2.2 cm (mean) | RFA | 10-year RFS: 94.2% | 10-year OS: 91.1% | — |
| Knox et al41 | 234 (all CA) | T1a and T1b | 2.5 cm (mean) | CA | Local recurrence last follow-up: 1.5% Metastases last follow-up: 5.2% |
10-year ACM: 2.7% | eGFR 70.32 (preprocedure), 67.92 (3-month postprocedure, p=0.01) |
| Pecoraro et al42 | 5763 (5521 PN and 242 CA) | T1b | 46.9 mm (CA), 51.0 mm (PN, median) | CA | CSM: HR 2.50, p=0.03 (CA/PN reference) OCM: HR 1.45, p=0.12 (CA/PN reference) |
— | |
| Klapperich et al43 | 100 | cT1a | 2.6 cm (median) | MWA | — | 3-year PFS: 88% 3-year CSS: 100% 3-year OS: 91% |
eGFR: 57.9 (preablation), 44 (6-month postablation), p=0.5 |
| Guo and Arellano44 | 119 | cT1a | 2.4 cm (mean) | MWA | PFS at 1, 2, and 3 years: 100%, 92.8%, and 90.6% | OS at 1, 2, and 3 years: 99.0%, 97.7%, and 94.6% | — |
| Guo and Arellano45 | 23 | cT1b | 5.2 cm (mean) | MWA | PFS at 1, 2 and 3 years: 100%, 90.9%, and 90.9% | OS at 1, 2, and 3 years: 95.2%, 85.7%, and 71.4% | — |
| Shapiro et al46 | 325 (40 MWA, 74 PN, 211 RN) | T1b | 4.4 cm (MWA), 4.7 cm (PN), 5 cm (RN) | MWA | 5-year RFS: 94.5% (MWA), 97.9% (PN, p=0.58) and 99.2% (RN, p=0.02) | 5-year CSS: 100% (MWA), 97.6% (PN, p=0.45) and 95.5% (RN, p=0.32) | Median ΔeGFR at 3 months: −4.5% (MWA), −3.2% (PN, p=0.65), and −29% (RN, p<0.001) |
Abbreviations: RFA, radiofrequency ablation; RN, radical nephrectomy; RFS, recurrence-free survival; OS, overall survival; CSS, cancer-specific survival; eGFR, estimated glomerular filtration rate; CA, cryoablation; ACM, all-cause mortality; PN, partial nephrectomy; CSM, cancer-specific mortality; OCM, other-cause mortality; MWA, microwave ablation; PFS, progression-free survival.