title: Radiofrequency ablation versus partial nephrectomy for treatment of renal masses: A systematic review and meta-analysis.
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.
authors.affiliation: Department of Urologic Surgery, Changzheng Hospital of the Second Military Medical University, Shanghai, China; Department of Urologic Surgery, Third Affiliated Hospital of the Second Military Medical University, Shanghai, China.
authors.forename: Xiu-Wu
authors.initials: XW
authors.lastname: Pan
authors.affiliation: Department of EENT and Plastic and Maxillofacial Surgery, Nangang Branch of Heilongjiang Provincial Hospital, Heilongjiang Province, China.
authors.forename: Xin-Ming
authors.initials: XM
authors.lastname: Cui
authors.affiliation: Department of Urologic Surgery, Changzheng Hospital of the Second Military Medical University, Shanghai, China.
authors.forename: Hai
authors.initials: H
authors.lastname: Huang
authors.affiliation: Department of Urologic Surgery, Changzheng Hospital of the Second Military Medical University, Shanghai, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Urologic Surgery, Changzheng Hospital of the Second Military Medical University, Shanghai, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Urologic Surgery, Changzheng Hospital of the Second Military Medical University, Shanghai, China.
authors.forename: Zhi-Jun
authors.initials: ZJ
authors.lastname: Wang
authors.affiliation: Department of Urologic Surgery, Changzheng Hospital of the Second Military Medical University, Shanghai, China.
authors.forename: Fa-Jun
authors.initials: FJ
authors.lastname: Qu
authors.affiliation: Department of Urologic Surgery, Changzheng Hospital of the Second Military Medical University, Shanghai, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Urologic Surgery, Third Affiliated Hospital of the Second Military Medical University, Shanghai, China. Electronic address: cuixingang_smmu@126.com.
authors.forename: Xin-Gang
authors.initials: XG
authors.lastname: Cui
authors.affiliation: Department of Urologic Surgery, Changzheng Hospital of the Second Military Medical University, Shanghai, China.
authors.forename: Dan-Feng
authors.initials: DF
authors.lastname: Xu
mesh_terms: D017115:Catheter Ablation; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology / Q000601:surgery; D007680:Kidney Neoplasms / Q000503:physiopathology / Q000601:surgery*; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009392:Nephrectomy; D016019:Survival Analysis; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: High-risk patients; Partial nephrectomy; Radiofrequency ablation; Renal masses