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A multicenter comparative matched-pair analysis of percutaneous tumor ablation and robotic-assisted partial nephrectomy of T1b renal cell carcinoma (AblatT1b study—UroCCR 80)

  • Vascular-Interventional
  • Published:
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Abstract

Objective

Renal cell carcinomas represent the sixth- and tenth-most frequently diagnosed cancer in men and women. Recently, percutaneous-guided thermal ablations have proved to be as effective as partial nephrectomy and safer for treating small renal masses (i.e.,  < 3 cm). This study compared the perioperative and recurrence outcomes of percutaneous thermal ablation (TA) and robotic-assisted partial nephrectomy (RAPN) for the treatment of T1b renal cell carcinomas (4.1–7 cm).

Methods

Retrospective data from 11 centers on the national database, between 2010 and 2020, included 81 patients treated with thermal ablation (TA) and 308 patients treated with RAPN for T1b renal cell carcinoma, collected retrospectively and matched for tumor size, histology results, and the RENAL score. TA included cryoablation and microwave ablation. Endpoints compared the rate between the two groups: local recurrence, metastases, complications, renal function decrease, and length of hospitalization.

Results

After matching, 75 patients were included in each group; mean age was 76.6 (± 9) in the TA group and 61.1 (± 12) in the RAPN group, including 69.3% and 76% men respectively. The local recurrence (LR) rate was significantly higher in the TA group than in the PN group (14.6% vs 4%; p = 0.02). The LR rate was 20% (1/5) after microwave ablation, 11.1% (1/9) after radiofrequency ablation, and 14.7% (9/61) after cryoablation. The major complication rate (Clavien–Dindo  ≥ 3) was higher following PN than after TA (5.3% vs 0%; p < 0.001). Metastases, eGFR decrease, and length of hospitalization did not differ significantly between the two groups.

Conclusions

The local recurrence rate was significantly higher after thermal ablation; however, thermal ablation resulted in significantly lower rates of complications.

Summary statement

Thermal ablation and robotic-assisted partial nephrectomy are effective treatments for T1b renal cancer; however, the local recurrence rate was higher after thermal ablation.

Key Points

• The local recurrence rate was significantly higher in the thermal ablation group than in the partial nephrectomy group.

• The major complication rate (Clavien–Dindo ≥ 3) was higher following PN than after TA (5.3% vs. 0%; p < 0.001).

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Abbreviations

CA:

Cryoablation

eGFR:

Estimated glomerular filtration rate

LR:

Local recurrence

MWA:

Microwave ablation

PN:

Partial nephrectomy

RAPN:

Robotic-assisted partial nephrectomy

RCC:

Renal cell carcinoma

RFA:

Radiofrequency ablation

RN:

Radical nephrectomy

STE:

Secondary technical efficacy

TA:

Thermal ablation

TE:

Technical efficacy

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Funding

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

Author information

Authors and Affiliations

  1. Service d’imagerie diagnostique et thérapeutique de l’adulte, Hôpital Pellegrin, place Amélie-Raba-Léon, 33076, Bordeaux, France

    Grégoire Cazalas, Nicolas Grenier & Clément Marcelin

  2. Service d’urologie, andrologie et transplantation rénale, Hôpital Pellegrin, place Amélie-Raba-Léon, 33076, Bordeaux, France

    Clément Klein, Clément Michiels & Jean Christophe Bernhard

  3. Department of Radiology, Institut Paoli-Calmettes, Marseille, France

    Gilles Piana

  4. Department of Radiology, Hôpital Saint-Louis 1, avenue Claude Vellefaux, 75010, Paris, France

    Eric De Kerviler

  5. Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France

    Afshin Gangi

  6. Department of Radiology CHU Lille, Radiology Department, Lille, France

    Philippe Puech

  7. Department of Radiology, University Hospital, CHU Angers, 4 rue Larrey, 49933, Angers, France

    Cosmina Nedelcu

  8. Department of Radiology, CHU Nord Saint-Etienne Avenue Albert Raimond, Saint Etienne, France

    Remi Grange

  9. Department of Interventional Radiology, Institut Bergonié, Bordeaux, France

    Xavier Buy

  10. Department of Radiology CHU Ponchaillou, Rennes, France

    Marc-Antoine Jegonday

  11. Department of Urology, University Hospital of Angers, Angers, France

    Pierre Bigot

  12. Department of Urology, CHU Ponchaillou, Rennes, France

    Charles Karim Bensalah

  13. Department of Urology, University Hospital of Strasbourg, Strasbourg, France

    Victor Gaillard

  14. Department of Urology, Institut Paoli-Calmettes, Marseille, France

    Géraldine Pignot

  15. Service d’Urologie, Centre Hospitalier Lyon Sud, Pierre Bénite, France

    Philippe Paparel

  16. Service d’Urologie, Hôpital Edouard Herriot, Lyon, France

    Lionel Badet

  17. Department of Radiology - Pavillon B, Hôpital E. Herriot, 69003, Lyon, France

    Olivier Rouviere

Authors
  1. Grégoire Cazalas
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  2. Clément Klein
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  3. Gilles Piana
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  7. Cosmina Nedelcu
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  8. Remi Grange
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  9. Xavier Buy
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  10. Marc-Antoine Jegonday
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  12. Charles Karim Bensalah
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  13. Victor Gaillard
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  14. Géraldine Pignot
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  15. Philippe Paparel
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  16. Lionel Badet
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  17. Clément Michiels
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  18. Jean Christophe Bernhard
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  19. Olivier Rouviere
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  20. Nicolas Grenier
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  21. Clément Marcelin
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Corresponding author

Correspondence to Clément Marcelin.

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Guarantor

The scientific guarantor of this publication is Nicolas Grenier.

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

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No complex statistical methods were necessary for this paper.

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• retrospective

• observational

• multicenter study

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Cazalas, G., Klein, C., Piana, G. et al. A multicenter comparative matched-pair analysis of percutaneous tumor ablation and robotic-assisted partial nephrectomy of T1b renal cell carcinoma (AblatT1b study—UroCCR 80). Eur Radiol 33, 6513–6521 (2023). https://doi.org/10.1007/s00330-023-09564-6

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