European Radiology

, Volume 28, Issue 7, pp 2979–2985 | Cite as

RFA versus robotic partial nephrectomy for T1a renal cell carcinoma: a propensity score-matched comparison of mid-term outcome

  • Byung Kwan Park
  • In Hyuck Gong
  • Min Yong Kang
  • Hyun Hwan Sung
  • Hwang Gyun Jeon
  • Byong Chang Jeong
  • Seong Soo Jeon
  • Hyun Moo Lee
  • Seong Il SeoEmail author



To compare oncological and functional mid-term outcomes following robotic partial nephrectomy (RPN) and radiofrequency ablation (RFA) for treating T1a renal cell carcinoma (RCC) using propensity score-matching.


Between December 2008–April 2016, 63 patients from each treatment group were propensity score-matched for age, sex, American Society of Anesthesiologists score, tumour size, tumour laterality, tumour histology, R.E.N.A.L. nephrometry score and preoperative estimated glomerular filtration rate (eGFR). Post-treatment follow-up periods for RPN and RFA ranged from 1–90 months (median, 24.6) and 1–65 months (21), respectively. Tumour location, percentage of eGFR preservation and 2-year recurrence-free survival rate were compared between groups.


Exophytic and endophytic RCC occurred in 73.0 % (46/63) and 27.0 % (17/63) of the RPN group, and 52.4 % (33/63) and 47.6 % (30/63) of the RFA group, respectively (p=0.017). There was 91.7 % preservation of eGFR in the RPN group and 86.8 % in the RFA group (p=0.088). Two-year recurrence-free survival rate was 100 % in the RPN and 95.2 % in the RFA group (p=0.029).


RPN provides a higher recurrence-free survival rate than RFA. However, RFA is a better treatment option for an endophytic or recurrent RCC that is difficult to treat with RPN.

Key Points

• RPN provides a higher recurrence-free survival rate than RFA.

• Unlike RPN, repeat RFA is easy to perform for recurrent RCC.

• Endophytic RCC could be better treated with RFA.


Radiofrequency catheter ablation Carcinoma, Renal cell Nephrectomy Treatment outcome Kidney 



American Society of Anesthesiology


Estimated glomerular filtration rate


Radius, Exophytic/Endophytic, Nearness to collecting system, Anterior/Posterior, Location relative to polar lines


Renal cell carcinoma


Radiofrequency ablation


Robotic partial nephrectomy



The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Dr. Kyu-Sung Lee.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

During the preparation of our manuscript we have consulted Keumhee Cho, PhD, an expert in statistics/biometry from the Samsung Medical Center, Biostatistics and Clinical Epidemiology Center.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.


• Retrospective

• Case-control study

• Performed at one institution


  1. 1.
    Patard JJ, Rodriguez A, Rioux-Leclercq N, Guille F, Lobel B (2002) Prognostic significance of the mode of detection in renal tumours. BJU Int 90:358–363CrossRefPubMedGoogle Scholar
  2. 2.
    Kim EY, Park BK, Kim CK, Lee HM (2010) Clinico-radio-pathologic features of a solitary solid renal mass at MDCT examination. Acta Radiol 51:1143–1148CrossRefPubMedGoogle Scholar
  3. 3.
    Zagoria RJ, Pettus JA, Rogers M, Werle DM, Childs D, Leyendecker JR (2011) Long-term outcomes after percutaneous radiofrequency ablation for renal cell carcinoma. Urology 77:1393–1397CrossRefPubMedGoogle Scholar
  4. 4.
    Psutka SP, Feldman AS, McDougal WS, McGovern FJ, Mueller P, Gervais DA (2013) Long-term oncologic outcomes after radiofrequency ablation for T1 renal cell carcinoma. Eur Urol 63:486–492CrossRefPubMedGoogle Scholar
  5. 5.
    Lorber G, Glamore M, Doshi M, Jorda M, Morillo-Burgos G, Leveillee RJ (2014) Long-term oncologic outcomes following radiofrequency ablation with real-time temperature monitoring for T1a renal cell cancer. Urol Oncol 32:1017–1023CrossRefPubMedGoogle Scholar
  6. 6.
    Chang X, Liu T, Zhang F et al (2015) Radiofrequency ablation versus partial nephrectomy for clinical T1a renal-cell carcinoma: long-term clinical and oncologic outcomes based on a propensity score analysis. J Endourol 29:518–525CrossRefPubMedGoogle Scholar
  7. 7.
    Khalifeh A, Autorino R, Eyraud R et al (2013) Three-year oncologic and renal functional outcomes after robot-assisted partial nephrectomy. Eur Urol 64:744–750CrossRefPubMedGoogle Scholar
  8. 8.
    Hu JC, Treat E, Filson CP et al (2014) Technique and outcomes of robot-assisted retroperitoneoscopic partial nephrectomy: a multicenter study. Eur Urol 66:542–549CrossRefPubMedGoogle Scholar
  9. 9.
    Satkunasivam R, Tsai S, Syan S et al (2015) Robotic unclamped "minimal-margin" partial nephrectomy: ongoing refinement of the anatomic zero-ischemia concept. Eur Urol 68:705–712CrossRefPubMedGoogle Scholar
  10. 10.
    Andrade HS, Zargar H, Caputo PA et al (2016) Five-year Oncologic Outcomes After Transperitoneal Robotic Partial Nephrectomy for Renal Cell Carcinoma. Eur Urol 69:1149–1154CrossRefPubMedGoogle Scholar
  11. 11.
    Kim HJ, Park BK, Park JJ, Kim CK (2016) CT-Guided Radiofrequency Ablation of T1a Renal Cell Carcinoma in Korea: Mid-Term Outcomes. Korean J Radiol 17:763–770CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Katsanos K, Mailli L, Krokidis M, McGrath A, Sabharwal T, Adam A (2014) Systematic review and meta-analysis of thermal ablation versus surgical nephrectomy for small renal tumours. Cardiovasc Intervent Radiol 37:427–437CrossRefPubMedGoogle Scholar
  13. 13.
    Olweny EO, Park SK, Tan YK, Best SL, Trimmer C, Cadeddu JA (2012) Radiofrequency ablation versus partial nephrectomy in patients with solitary clinical T1a renal cell carcinoma: comparable oncologic outcomes at a minimum of 5 years of follow-up. Eur Urol 61:1156–1161CrossRefPubMedGoogle Scholar
  14. 14.
    Whitson JM, Harris CR, Meng MV (2012) Population-based comparative effectiveness of nephron-sparing surgery vs ablation for small renal masses. BJU Int 110:1438–1443 discussion 1443CrossRefPubMedGoogle Scholar
  15. 15.
    Thompson RH, Atwell T, Schmit G et al (2015) Comparison of partial nephrectomy and percutaneous ablation for cT1 renal masses. Eur Urol 67:252–259CrossRefPubMedGoogle Scholar
  16. 16.
    Stern JM, Svatek R, Park S et al (2007) Intermediate comparison of partial nephrectomy and radiofrequency ablation for clinical T1a renal tumours. BJU Int 100:287–290CrossRefPubMedGoogle Scholar
  17. 17.
    Pantelidou M, Challacombe B, McGrath A et al (2016) Percutaneous Radiofrequency Ablation Versus Robotic-Assisted Partial Nephrectomy for the Treatment of Small Renal Cell Carcinoma. Cardiovasc Intervent Radiol 39:1595–1603CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Ljungberg B, Bensalah K, Canfield S et al (2015) EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol 67:913–924CrossRefPubMedGoogle Scholar
  19. 19.
    Campbell SC, Novick AC, Belldegrun A et al (2009) Guideline for management of the clinical T1 renal mass. J Urol 182:1271–1279CrossRefPubMedGoogle Scholar
  20. 20.
    Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 130:461–470CrossRefPubMedGoogle Scholar
  21. 21.
    Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Inker LA, Astor BC, Fox CH et al (2014) KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis 63:713–735CrossRefPubMedGoogle Scholar
  23. 23.
    Sung HH, Park BK, Kim CK, Choi HY, Lee HM (2012) Comparison of percutaneous radiofrequency ablation and open partial nephrectomy for the treatment of size- and location-matched renal masses. Int J Hyperthermia 28:227–234CrossRefPubMedGoogle Scholar
  24. 24.
    Park SY, Park BK, Kim CK (2012) Thermal ablation in renal cell carcinoma: what affects renal function? Int J Hyperthermia 28:729–734CrossRefPubMedGoogle Scholar
  25. 25.
    Choi JD, Park JW, Choi JY et al (2010) Renal damage caused by warm ischaemia during laparoscopic and robot-assisted partial nephrectomy: an assessment using Tc 99m-DTPA glomerular filtration rate. Eur Urol 58:900–905CrossRefPubMedGoogle Scholar
  26. 26.
    Choi JD, Park JW, Lee SY et al (2012) Does prolonged warm ischemia after partial nephrectomy under pneumoperitoneum cause irreversible damage to the affected kidney? J Urol 187:802–806CrossRefPubMedGoogle Scholar

Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Byung Kwan Park
    • 1
  • In Hyuck Gong
    • 2
  • Min Yong Kang
    • 2
  • Hyun Hwan Sung
    • 2
  • Hwang Gyun Jeon
    • 2
  • Byong Chang Jeong
    • 2
  • Seong Soo Jeon
    • 2
  • Hyun Moo Lee
    • 2
  • Seong Il Seo
    • 2
    Email author
  1. 1.Department of Radiology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
  2. 2.Department of Urology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea

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