Presentation Authors: Federico Mineo Bianchi, Francesco Chessa*, Riccardo Schiavina, Bologna, Italy, Bernardino De Concilio, Bassano del Grappa, Italy, Marco Borghesi, Pietro Piazza, Lorenzo Bianchi, Cristian Vincenzo Pultrone, Fabrizio Sartorio, Serena Di Fresco, Marco Guerra, Andrea Angiolini, Carlo Beretta, Umberto Barbaresi, Eugenio Brunocilla, Bologna, Italy, Antonio Celia, Bassano del Grappa, Italy
Introduction: To compare perioperative and oncologic outcomes between Partial nephrectomy (PN) and Cryoablation (CA).
Methods: We undertook propensity score match (Age, ASA score, tumor size, PADUA score) analysis of patients who underwent CA (percutaneous or laparoscopic) or PN (laparoscopic or robotic). Clinicopathologic and perioperative outcomes were compared. To assess the Disease-free survival and cancer specific survival, patients with diagnosis of oncocytoma were excluded from final analysis.
Results: Overall, data from 164 patients who underwent CA (82 patients) or PN (82 patients) were analyzed. Clinicopathological and post-operative outcomes of patients are reported in table 1a. The two groups were similar regarding sex, age, ASA score, clinical tumor size, PADUA risk group and histology. Preoperative creatinine was lower in the PN group (p=0.004). Post-operative complications rate was similar between the two groups. Mean follow up was 34 months for the PN group and 54 months in the CA group (p < 0.001). Mean serum creatinine variation was significantly higher in the PN (+0.1mg/dL) group than in the CA (+0.002 mg/dL) group (p < 0.001) Overall, local recurrence occurred in 14 (10%) patients, 3 (4%) in the PN group and 11 (15%) in the CA group (Fig 1a), respectively (p=0.03). At univariable analysis main predictors of recurrence were intermediate/high PADUA risk group and CA (Tab 1b).
Conclusions: In our propensity score match analysis, PN provides better cancer control then CA at the cost of little but significant impairment of renal function. Particularly in elderly patients, the selection of the best treatment is crucial to find the optimal balance between the cancer control and treatment&[prime]s related morbidity.