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Cancer-Specific Mortality Associated With Cryoablation for Renal Cell Carcinoma

By: Joseph Fanelli
Posted: Thursday, January 23, 2020

According to findings presented in The Journal of Urology, administering cryoablation to patients with primary tumor subtype 1b (pT1b) renal cell carcinoma may result in increased cancer-specific mortality. Angela Pecoraro, MD, of the University of Turin, Italy, and colleagues discovered these results while investigating the differences between treatment with cryoablation and partial nephrectomy.

“This observation should be interpreted as a contraindication to cryoablation outside clinical trials or institutional protocols,” the authors concluded.

In this trial, the investigators identified 5,763 patients diagnosed with pT1b tumors using the Surveillance, Epidemiology, and End Results (SEER) database. Patients were treated with cryoablation (n = 242) or partial nephrectomy (n = 5,521). The authors noted that those who received cryoablation were typically older, had smaller tumors, and harbored unclassified renal carcinoma of low or unknown grades at higher rates than those treated with cryoablation.

After a median follow-up of 38 months, the investigators reported that patients treated with cryoablation experienced 5-year cancer-specific mortality rates that were 2.5 times higher than patients who received partial nephrectomy, after propensity-score matching and other-cause mortality adjustment. In contrast, after propensity-score matching and cancer-specific mortality adjustment, the 5-year other-cause mortality rate for those treated with partial nephrectomy was “similar” to the rate for those who received cryoablation (hazard ratio = 1.45).

In multivariable logistic regression models that predicted cryoablation compared with partial nephrectomy, older patient age was an independent predictor.

Disclosure: For full disclosures of the study authors, visit www.auajournals.org.



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