Compared to radical nephrectomy, percutaneous ablation provides similar oncologic outcomes with fewer complications in older patients with small renal tumors, results of a large, population-based comparative analysis suggest.
The benefits of percutaneous ablation were less certain when compared to partial nephrectomy, though patients undergoing ablation appeared to have fewer complications, according to investigator Adam D. Talenfeld, MD, MS of Weill Cornell Medicine and NewYork-Presbyterian, New York.
This first-ever population-level study of percutaneous ablation outcomes strengthens findings of single-institution studies, and raises the level of evidence supporting its use in well-selected older patients, Dr. Talenfeld said in an interview with Urology Times.
“The real question here is, for those older patients that can't get partial nephrectomy, are we doing the right thing by taking out their kidneys? And I think the answer is probably more often than not, no,” he said. “I think that we should consider percutaneous ablation ahead of radical nephrectomy for older patients when partial nephrectomy is considered less feasible.”
The observational cohort analysis by Dr. Talenfeld and colleagues, published in the Annals of Internal Medicine (June 26, 2018 [epub ahead of print]), was based on data from the SEER (Surveillance, Epidemiology, and End Results) cancer registry tied to Medicare claims data.
The investigators included data for a total of 4,310 individuals aged 66 years or older who underwent treatment for T1a renal cell carcinoma (RCC) between 2006 and 2011.