title: A comparison of long term renal functional outcomes following partial nephrectomy and radiofrequency ablation.
abstract: BACKGROUND
  To compare long term glomerular filtration rate (GFR) outcomes of partial nephrectomy and radiofrequency ablation performed for renal malignancy.
  
  
  METHODS
  Renal function of 347 patients undergoing radiofrequency ablation (n = 142) or partial nephrectomy (n = 205) for renal malignancy between 1994 and 2011 were compared from a retrospective database at a single tertiary care center. Minimum 1 year of follow up was required, resulting in a mean follow up of 48.2 (SD +/- 28.2) months. Renal function was estimated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. The primary study outcome was progression of Chronic Kidney Disease (CKD) stage, calculated using the Kaplan-Meier life table method. Multivariate analysis was also conducted to determine the level of association between GFR decline and treatment modality.
  
  
  RESULTS
  The 5 year freedom from CKD stage progression for radiofrequency ablation and partial nephrectomy was 85.4% (95% CI 76.8%-91.1%) versus 82.1% (95% CI 73.7%-88.1%) (p = 0.06). A longer follow up interval was associated with greater GFR decline, although hypertension, diabetes, age, and tumor size were not.
  
  
  CONCLUSIONS
  Radiofrequency ablation provides similar long term renal function preservation benefit as partial nephrectomy.
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Faddegon
authors.forename: Tom
authors.initials: T
authors.lastname: Ju
authors.forename: Ephrem O
authors.initials: EO
authors.lastname: Olweny
authors.forename: Zhuowei
authors.initials: Z
authors.lastname: Liu
authors.forename: Woong K
authors.initials: WK
authors.lastname: Han
authors.forename: Gang
authors.initials: G
authors.lastname: Yin
authors.forename: Yung K
authors.initials: YK
authors.lastname: Tan
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Gahan
authors.forename: Selahattin
authors.initials: S
authors.lastname: Bedir
authors.forename: Yun-Bo
authors.initials: YB
authors.lastname: Ma
authors.forename: Samuel K
authors.initials: SK
authors.lastname: Park
authors.forename: Ganesh V
authors.initials: GV
authors.lastname: Raj
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Cadeddu
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000503:physiopathology* / Q000601:surgery*; D007680:Kidney Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009392:Nephrectomy / Q000379:methods*; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D016896:Treatment Outcome