TY - JOUR
T1 - Comparison of renal function detriments after local tumor ablation or partial nephrectomy for renal cell carcinoma
AU - Larcher, Alessandro
AU - Meskawi, Malek
AU - Valdivieso, Roger
AU - Boehm, Katharina
AU - Trudeau, Vincent
AU - Tian, Zhe
AU - Fossati, Nicola
AU - Dell’Oglio, P.
AU - Lughezzani, Giovanni
AU - Buffi, Nicolò
AU - Sun, M.
AU - Karakiewicz, Pierre I.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Purpose: Local tumor ablation (LTA) and partial nephrectomy (PN) represent treatment alternatives for patients diagnosed with small renal mass and both may result in renal function detriments. The aim of the study was to compare renal function detriments after LTA or PN. Methods: A Surveillance epidemiology and End Results-Medicare-linked retrospective cohort of 2850 T1 kidney cancer patients who underwent LTA or PN was abstracted. Short-term outcomes consisted of 30-day acute kidney injury (AKI) and 30-day dialysis rates. Long-term outcomes consisted of episodes of AKI, mild and moderate–severe chronic kidney disease (CKD), end-stage renal disease, hemodialysis and anemia in CKD. Analyses consisted of propensity score matching, logistic and Cox regression. Results: After propensity score matching, 1122 patients remained. The 30-day incidence of AKI was 4.6 % after LTA and 9.4 % after PN. In multivariable analyses (MVAs), LTA was associated with a lower AKI rate (OR 0.42; p = 0.001). The 30-day incidence of any dialysis was 0.5). Conclusions: LTA offers short-term protective effect from AKI. The short-term rates of any dialysis treatment are similar after either LTA or PN. At long-term assessment, LTA and PN renal function detriment rates are not different. Concern for long-term functional outcomes should not be a barrier for PN.
AB - Purpose: Local tumor ablation (LTA) and partial nephrectomy (PN) represent treatment alternatives for patients diagnosed with small renal mass and both may result in renal function detriments. The aim of the study was to compare renal function detriments after LTA or PN. Methods: A Surveillance epidemiology and End Results-Medicare-linked retrospective cohort of 2850 T1 kidney cancer patients who underwent LTA or PN was abstracted. Short-term outcomes consisted of 30-day acute kidney injury (AKI) and 30-day dialysis rates. Long-term outcomes consisted of episodes of AKI, mild and moderate–severe chronic kidney disease (CKD), end-stage renal disease, hemodialysis and anemia in CKD. Analyses consisted of propensity score matching, logistic and Cox regression. Results: After propensity score matching, 1122 patients remained. The 30-day incidence of AKI was 4.6 % after LTA and 9.4 % after PN. In multivariable analyses (MVAs), LTA was associated with a lower AKI rate (OR 0.42; p = 0.001). The 30-day incidence of any dialysis was 0.5). Conclusions: LTA offers short-term protective effect from AKI. The short-term rates of any dialysis treatment are similar after either LTA or PN. At long-term assessment, LTA and PN renal function detriment rates are not different. Concern for long-term functional outcomes should not be a barrier for PN.
KW - Acute kidney injury
KW - Chronic kidney disease
KW - Dialysis
KW - Kidney cancer
KW - Local tumor ablation
KW - Nephron-sparing surgery
KW - Partial nephrectomy
KW - Renal function
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U2 - 10.1007/s00345-015-1606-4
DO - 10.1007/s00345-015-1606-4
M3 - Article
VL - 34
SP - 383
EP - 389
JO - World Journal of Urology
JF - World Journal of Urology
SN - 0724-4983
IS - 3
ER -