[Perioperative outcomes and mid-term results of radiofrequency ablation and partial nephrectomy in indications of renal tumor treatment and imperative nephron-sparing procedure].
OBJECTIVE
To compare morbidity, oncological and functional outcomes of percutaneous radiofrequency ablation (RFA) and partial nephrectomy in indications of renal tumor treatment with imperative nephron-sparing procedure.


METHODS
Between January 2005 and December 2010, 50 consecutive patients were referred in our center for NP or RFA for a renal tumor with either a renal function impairment defined as estimated glomerular filtration (eGFR) less than 60 mL/min/1.73 m(2), and/or solitary kidney and/or bilateral tumors. Perioperative outcomes were compared.


RESULTS
Thirty-six PN and 14 RFA were performed. RFA patients were older (79.2 vs. 62.5 years old), had a higher ASA score (3 vs. 2), a lower RENAL score (6 vs. 7.5) and a lower rate of tumor on solitary kidney or bilateral tumors (P=0.009). Overall complications (29.4% vs. 6.3%), transfusions (20.6% vs. 0) and longer hospital stay (9 vs. 3 days) were more likely to occur in the NP group. During a median follow-up of 22 months (4.3-53.7), eGFR decrease was similar between the two groups (P=0.34). On multivariate analysis, PN was associated with an increased occurrence of overall complications (OR=14.09, P=0.02) but with a similar eGFR decrease. No patient died.


CONCLUSIONS
For patients with an indication of treatment of renal tumor and imperative nephron-sparing procedure, RFA seems to provide low morbidity and comparable functional outcomes as partial nephrectomy. Our limited follow-up does not permit to conclude on oncologic data.
Service d'urologie et transplantation rénale, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France. varnoux@chu-grenoble.fr
V
V
Arnoux
J-L
JL
Descotes
C
C
Sengel
N
N
Terrier
J-J
JJ
Rambeaud
J-A
JA
Long
D000368:Aged; D015992:Body Mass Index; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D059351:Organ Sparing Treatments; D059035:Perioperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome