Open AccessRadiofrequency ablation versus partial nephrectomy for treatment of renal masses: A systematic review and meta‐analysis
Author(s) -
Pan XiuWu,
Cui XinMing,
Huang Hai,
Huang Yi,
Li Lin,
Wang ZhiJun,
Qu FaJun,
Gao Yi,
Cui XinGang,
Xu DanFeng
Publication year - 2015
Publication title -
the kaohsiung journal of medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.439
H-Index - 36
eISSN - 2410-8650
pISSN - 1607-551X
DOI - 10.1016/j.kjms.2015.09.007
Subject(s) - medicine , radiofrequency ablation , perioperative , meta analysis , nephrectomy , renal function , odds ratio , urology , surgery , ablation , kidney
Abstract Our study was to collect the data available in the literature on radiofrequency ablation (RFA) and partial nephrectomy (PN) and conduct a cumulative analysis on perioperative outcomes, renal function outcomes, and survival to evaluate the overall safety and efficacy of RFA versus PN for small renal cell cancer (SRCC). A literature search was carried out using various electronic databases. Data including age, tumor size, comorbid disease, operation duration, hospital stay, pre‐ and postoperative estimated glomerular filtration rate (eGFR), major and minor complications, and local tumor recurrence and metastasis were collected for meta‐analysis. Sixteen studies were included for this meta‐analysis. The age of patients treated with RFA was significantly older than that of patients treated with PN [weighted mean difference (WMD) = 5.07 years]. There were more patients with cardiovascular disease in RFA group as compared with PN group [odds ratio (OR) = 4.24] before treatment. RFA was associated with a shorter length of hospital stay compared with PN (WMD = −2.02 days). No significant difference was found in major and minor complications between the two groups (major: OR = 0.74; minor: OR = 0.45). Preoperative eGFR and eGFR decline in RFA patients was significantly lower than that in PN patients (WMD = −7.27 and −4.82, respectively), whereas there was no significant difference in postoperative eGFR (WMD = −1.18). The local tumor recurrence rate in RFA group was higher than that in PN group (OR = 1.81). However, the distant metastasis rate was no statistical difference between the two groups (OR = 1.63). RFA is a suitable therapeutic option for older patients and those at high risk for SRCC because of a low risk of operation and better preservation of renal function.