Skip to main content

Partial nephrectomy versus ablative therapy for the treatment of renal tumors in an imperative setting



To compare partial nephrectomy (PN) and percutaneous ablative therapy (AT) for renal tumor in imperative indication of nephron-sparing technique (NST).

Materials and methods

Between 2000 and 2015, 284 consecutive patients with a kidney tumor in an imperative indication of NST were retrospectively included in a multicenter study. PN [open (n = 146), laparoscopic (n = 9), or robotic approach (n = 17)] and AT [radiofrequency ablation (n = 104) or cryoablation (n = 8)] were performed for solitary kidney (n = 146), bilateral tumor (n = 78), or chronic kidney disease (CKD) (n = 60).


Patients in the PN group had larger tumors and a higher RENAL score. There were no differences between the two groups with respect to age, reasons for imperative indication, and preoperative eGFR. Patients in the AT group had a higher ASA and CCI. PN had worse outcomes than AT in terms of transfusion rate, length of stay, and complication rate. Local radiological recurrence-free survival was better for PN, but metastatic recurrence was similar. Percentage of eGFR decrease was similar in the two groups. Temporary or permanent dialysis was not significantly different. On multivariate analysis, PN and AT had a similar eGFR change when adjusted for tumor complexity, reason of imperative indication and CCI.


In imperative indication of nephron-sparing treatment for a kidney tumor, either PN or AT can be proposed. PN offers the ability to manage larger and more complex tumors while providing a better local control and a similar renal function loss.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2


  1. Long J-A, Lee B, Eyraud R et al (2012) Robotic partial nephrectomy: imperative vs elective indications. Urology 80:833–837

    Article  PubMed  Google Scholar 

  2. Ljungberg B, Bensalah K, Canfield S et al (2015) EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol 67:913–924

    Article  PubMed  Google Scholar 

  3. Guillotreau J, Haber G-P, Autorino R et al (2012) Robotic partial nephrectomy versus laparoscopic cryoablation for the small renal mass. Eur Urol 61:899–904

    Article  PubMed  Google Scholar 

  4. Psutka SP, Feldman AS, McDougal WS et al (2013) Long-term oncologic outcomes after radiofrequency ablation for T1 renal cell carcinoma. Eur Urol 63:486–492

    Article  PubMed  Google Scholar 

  5. Dindo D, Demartines N, Clavien P-A (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed  PubMed Central  Google Scholar 

  6. Arnoux V, Descotes J-L, Sengel C et al (2013) Perioperative outcomes and mid-term results of radiofrequency ablation and partial nephrectomy in indications of renal tumor treatment and imperative nephron-sparing procedure. Prog En Urol J Assoc Fr Urol Société Fr Urol 23:99–104

    CAS  Article  Google Scholar 

  7. Larcher A, Fossati N, Tian Z et al (2015) Prediction of complications following partial nephrectomy: implications for ablative techniques candidates. Eur Urol 69:676–682

    Article  PubMed  Google Scholar 

  8. Trudeau V, Becker A, Roghmann F et al (2014) Local tumor destruction in renal cell carcinoma—an inpatient population-based study. Urol Oncol 32(54):e1–e7

    Google Scholar 

  9. Guillotreau J, Yakoubi R, Long J-A et al (2012) Robotic partial nephrectomy for small renal masses in patients with pre-existing chronic kidney disease. Urology 80:845–851

    Article  PubMed  Google Scholar 

  10. Long J-A, Yakoubi R, Lee B et al (2012) Robotic versus laparoscopic partial nephrectomy for complex tumors: comparison of perioperative outcomes. Eur Urol 61:1257–1262

    Article  PubMed  Google Scholar 

  11. Lane BR, Novick AC, Babineau D et al (2008) Comparison of laparoscopic and open partial nephrectomy for tumor in a solitary kidney. J Urol 179:847–851 (discussion 852)

    Article  PubMed  Google Scholar 

  12. Panumatrassamee K, Kaouk JH, Autorino R et al (2013) Cryoablation versus minimally invasive partial nephrectomy for small renal masses in the solitary kidney: impact of approach on functional outcomes. J Urol 189:818–822

    Article  PubMed  Google Scholar 

  13. El Dib R, Touma NJ, Kapoor A (2012) Cryoablation vs. radiofrequency ablation for the treatment of renal cell carcinoma: a meta-analysis of case series studies. BJU Int 110:510–516

    Article  PubMed  Google Scholar 

  14. Kunkle DA, Uzzo RG (2008) Cryoablation or radiofrequency ablation of the small renal mass: a meta-analysis. Cancer 113:2671–2680

    Article  PubMed  PubMed Central  Google Scholar 

  15. Tanagho YS, Bhayani SB, Kim EH et al (2013) Renal cryoablation versus robot-assisted partial nephrectomy: Washington University long-term experience. J Endourol Endourol Soc 27:1477–1486

    Article  Google Scholar 

  16. Thompson RH, Atwell T, Schmit G et al (2015) Comparison of partial nephrectomy and percutaneous ablation for cT1 renal masses. Eur Urol 67:252–259

    Article  PubMed  Google Scholar 

Download references

Author’s contribution

Jean-Alexandre Long was involved in project development, data management, data analysis, and manuscript writing; Jean-Christophe Bernhard and Pierre Bigot were involved in project development and data management; Cecilia Lanchon was involved in manuscript writing. Philippe Paparel, Nathalie Rioux-Leclercq, François-Xavier Nouhaud, Pierre Gimel, and Laurence Albiges were involved in data management; Thomas Bodin, Romain Boissier, Arnaud Méjean, Alexandra Masson-Lecomte, Nicolas Grenier, Francois Cornelis, Yohann Grassano, Vincent Comat, Quentin Come LE CLERC, Jérome Rigaud, Laurent Salomon, Jean-Luc Descotes, Christian Sengel, Morgan Roupret, Gregory Verhoest, Idir Ouzaid, and Valentin Arnoux were involved in data collection; and Karim Bensalah was involved in project development, data management, data analysis, and manuscript writing.

Author information

Authors and Affiliations



Corresponding author

Correspondence to Jean-Alexandre Long.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Long, JA., Bernhard, JC., Bigot, P. et al. Partial nephrectomy versus ablative therapy for the treatment of renal tumors in an imperative setting. World J Urol 35, 649–656 (2017).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • Renal cancer
  • Partial nephrectomy
  • Radiofrequency
  • Cryoablation
  • Imperative indication