To compare the progression risk and postoperative outcomes of image-guided tumor ablation versus surgical resection in patients with T1a renal cell carcinoma.
Approach:
Key Findings:
No significant difference in progression risk between ablation and resection after adjustment for confounders.
Ablation associated with shorter hospital stays (median 0 days) compared to resection and nephrectomy (median 2 days).
Local recurrence rates were 2% for ablation, 1% for resection, and 0% for nephrectomy.
Distant metastasis rates were similar for ablation and resection (approximately 2%), while nephrectomy had a rate of 4%.
Patients undergoing ablation were older and had more comorbidities compared to those undergoing resection.
Interpretation:
Both ablation and surgical resection are effective treatment options for T1a renal cell carcinoma, with ablation offering advantages in terms of hospital stay and postoperative contacts.
Limitations:
Retrospective registry design may introduce selection bias and unmeasured confounding.
Missing tumor size data for many patients undergoing ablation.
Specific complication types not systematically recorded.
Conclusion:
Despite a higher local recurrence rate in the ablation group, overall progression rates remained low across all treatment modalities, supporting the effectiveness of both options for T1a renal cell carcinoma.
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