Abstract
A recent report suggesting significant cost-effectiveness advantage for renal radiofrequency ablation (RFA) over partial nephrectomy makes assumptions about rates of local cancer recurrence, estimates of which are inexact at this point in time. Uncertainty regarding the oncologic efficacy of RFA technology and the expense and challenges of adequate post-treatment surveillance further confound this comparison. Partial nephrectomy remains the standard of care for nephron-sparing surgery, and should remain the preferred treatment in patients with an acceptable risk profile. Until longer-term follow-up data are available, RFA should be reserved for elderly patients and those with multiple comorbidities who have only a small renal mass.
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References
Pandharipande et al. (2008) Radiofrequency ablation versus nephron-sparing surgery for small unilateral renal cell carcinoma: cost-effectiveness analysis. Radiology 248: 169–178
Kunkle DA et al. (2008) Excise, ablate or observe: the small renal mass dilemma—a meta-analysis and review. J Urol 179: 1227–1233
Weight CJ et al. (2007) MRI is inadequate for monitoring renal tumor destruction following radiofrequency ablation [abstract #497]. J Urol 177: a496
Lane BR and Gill IS (2007) 5-year outcomes of laparoscopic partial nephrectomy. J Urol 177: 70–74
Fergany AF et al. (2000) Long-term results of nephron-sparing surgery for localized renal cell carcinoma: 10-year followup. J Urol 163: 442–445
Gill IS et al. (2007) Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol 178: 41–46
McDougal WS et al. (2005) Long-term follow-up of patients with renal cell carcinoma treated with radio frequency ablation with curative intent. J Urol 174: 61–63
Michaels MJ et al. (2002) Incomplete renal tumor destruction using radio frequency interstitial ablation. J Urol 168: 2406–2410
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Stein, R., Gill, I. Is radiofrequency ablation more cost-effective than nephron-sparing surgery for small unilateral renal cell carcinoma?. Nat Rev Urol 6, 6–7 (2009). https://doi.org/10.1038/ncpuro1239
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DOI: https://doi.org/10.1038/ncpuro1239
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