Intermediate-Term Oncologic Outcomes of Partial Nephrectomy Versus Cryoablation in Renal Tumors >3 cm: A Propensity Score Matched Analysis

No AccessJournal of UrologyOriginal Clinical Article12 Mar 2025Intermediate-Term Oncologic Outcomes of Partial Nephrectomy Versus Cryoablation in Renal Tumors >3 cm: A Propensity Score Matched Analysis Nicholas A. Pickersgill, Joel M. Vetter, Dylan J. Mittauer, Lauren Elson, Joshua K. Palka, Nimrod S. Barashi, Eric H. Kim, Ramakrishna Venkatesh, Sam B. Bhayani, and R. Sherburne Figenshau Nicholas A. PickersgillNicholas A. Pickersgill Corresponding author: Nicholas A. Pickersgill, MD, Urologic Oncology Fellow, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065. Phone: (314) 366-0525. Email: ([email protected]) https://orcid.org/0000-0001-9902-6603 , Joel M. VetterJoel M. Vetter Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA , Dylan J. MittauerDylan J. Mittauer Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA , Lauren ElsonLauren Elson Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA , Joshua K. PalkaJoshua K. Palka Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA Michigan Institute of Urology, Troy, MI, USA , Nimrod S. BarashiNimrod S. Barashi Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA , Eric H. KimEric H. Kim Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA Division of Urology, Department of Surgery, University of Nevada Reno School of Medicine, Reno, NV, USA , Ramakrishna VenkateshRamakrishna Venkatesh Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA , Sam B. BhayaniSam B. Bhayani Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA , and R. Sherburne FigenshauR. Sherburne Figenshau Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA View All Author Informationhttps://doi.org/10.1097/JU.0000000000004524AboutPDF Cite Export CitationSelect Citation formatNLMAMAIEEEACMAPAChicagoMLAHarvardTips on citation downloadDownload citationCopy citation ToolsAdd to favoritesTrack Citations ShareFacebookLinked InTwitterEmail Abstract Purpose: Cryoablation (CA) and partial nephrectomy (PN) are effective nephron-sparing treatments for small renal masses. While guidelines list thermal ablation as an option for tumors <3 cm, limited data compare PN and CA in larger tumors. We compared intermediate-term oncologic outcomes between PN and CA in renal masses >3 cm. Materials and Methods: Patients treated with PN or CA for cT1/cT2, N0M0 renal masses >3 cm between 2006 and 2016 were identified. Propensity score matching was performed in a 1:2 ratio for patients undergoing CA or PN based on age, BMI, Charlson Comorbidity Index (CCI), tumor size, and nephrometry score. Disease-free survival (DFS), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS) were estimated using Kaplan-Meier analysis. Results: One hundred thirteen and 57 patients underwent PN and CA with median follow-up of 4.5 and 3.8 years, respectively. CA was associated with significantly lower 5-year DFS compared to PN (75% vs. 94%, p<0.001). Local recurrence was more common after CA compared to PN (5.3% vs. 1.8%). Technical failure occurred with 32% of PCA. However, no significant differences were observed in 5-year MFS (100% for CA vs. 96% for PN, p=0.2) or CSS (100% for CA vs. 98% for PN, p=0.4). Conclusions: CA is associated with lower DFS but similar MFS and CSS compared to PN in renal masses >3 cm. CA is a viable option for well-selected patients with comorbidities or high surgical risk, when combined with salvage ablation as indicated. © 2025 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Supplementary Materials Advertisement Copyright & Permissions© 2025 by American Urological Association Education and Research, Inc.Keywordsrenal cell carcinomacryoablationpartial nephrectomy Author Information Nicholas A. Pickersgill Corresponding author: Nicholas A. Pickersgill, MD, Urologic Oncology Fellow, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065. Phone: (314) 366-0525. Email: ([email protected]) More articles by this author Joel M. Vetter Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA More articles by this author Dylan J. Mittauer Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA More articles by this author Lauren Elson Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA More articles by this author Joshua K. Palka Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA Michigan Institute of Urology, Troy, MI, USA More articles by this author Nimrod S. Barashi Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA More articles by this author Eric H. Kim Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA Division of Urology, Department of Surgery, University of Nevada Reno School of Medicine, Reno, NV, USA More articles by this author Ramakrishna Venkatesh Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA More articles by this author Sam B. Bhayani Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA More articles by this author R. Sherburne Figenshau Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA More articles by this author Expand All Advertisement PDF downloadLoading ...