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A Comparison of Functional and Oncologic Outcomes between Partial Nephrectomy and Radiofrequency Ablation in Patients with Chronic Kidney Disease after Propensity Score Matching
Purpose: This study aimed to compare functional and oncological outcomes between partial nephrectomy (PN) and radiofrequency ablation (RFA) for a small renal mass (SRM, ≤4 cm) in patients with chronic kidney disease (CKD). Materials and Methods: Patients with CKD who underwent either PN or RFA for S...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9600482/ https://www.ncbi.nlm.nih.gov/pubmed/36291981 http://dx.doi.org/10.3390/diagnostics12102292 |
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author | Ryoo, Hyunsoo Kang, Minyong Sung, Hyun Hwan Jeon, Hwang Gyun Jeong, Byong Chang Jeon, Seong Soo Lee, Hyun Moo Park, Byung Kwan Seo, Seong Il |
author_facet | Ryoo, Hyunsoo Kang, Minyong Sung, Hyun Hwan Jeon, Hwang Gyun Jeong, Byong Chang Jeon, Seong Soo Lee, Hyun Moo Park, Byung Kwan Seo, Seong Il |
author_sort | Ryoo, Hyunsoo |
collection | PubMed |
description | Purpose: This study aimed to compare functional and oncological outcomes between partial nephrectomy (PN) and radiofrequency ablation (RFA) for a small renal mass (SRM, ≤4 cm) in patients with chronic kidney disease (CKD). Materials and Methods: Patients with CKD who underwent either PN or RFA for SRM between 2005 and 2019 were included. Patients were stratified into two categories: CKD stage 2 and CKD stage 3 or higher. We performed propensity score matching (PSM) analysis in patients with CKD stage 2 and CKD stage 3 or higher. We compared the functional and oncological outcomes between two groups according to CKD stage before and after PSM. Results: Among 1332 patients, 1195 patients were CKD stage 2 and 137 patients were CKD stage 3 or higher. After PSM analysis using age, pre-treatment eGFR, and clinical tumor size as matching variables, the PN and RFA groups had 270 and 135 CKD stage 2 patients, respectively, and both had 53 patients each with CKD stage 3 or higher. There were no significant differences in percent change in eGFR at 1 year post-operation between groups in patients with CKD stage 2 and stage 3 or higher. Among all patients with tissue-proven malignancy, the 5-year recurrence-free survival (RFS), cancer-specific survival, and overall survival were significantly higher in the PN group. However, only the 5-year RFS was significantly higher in the PN group after matching. Conclusion: Mortality is low in patients with SRM, and functional outcomes were not significantly different between the two treatments. RFA could be an alternative treatment modality in patients who are poor candidates for surgery. |
format | Online Article Text |
id | pubmed-9600482 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96004822022-10-27 A Comparison of Functional and Oncologic Outcomes between Partial Nephrectomy and Radiofrequency Ablation in Patients with Chronic Kidney Disease after Propensity Score Matching Ryoo, Hyunsoo Kang, Minyong Sung, Hyun Hwan Jeon, Hwang Gyun Jeong, Byong Chang Jeon, Seong Soo Lee, Hyun Moo Park, Byung Kwan Seo, Seong Il Diagnostics (Basel) Article Purpose: This study aimed to compare functional and oncological outcomes between partial nephrectomy (PN) and radiofrequency ablation (RFA) for a small renal mass (SRM, ≤4 cm) in patients with chronic kidney disease (CKD). Materials and Methods: Patients with CKD who underwent either PN or RFA for SRM between 2005 and 2019 were included. Patients were stratified into two categories: CKD stage 2 and CKD stage 3 or higher. We performed propensity score matching (PSM) analysis in patients with CKD stage 2 and CKD stage 3 or higher. We compared the functional and oncological outcomes between two groups according to CKD stage before and after PSM. Results: Among 1332 patients, 1195 patients were CKD stage 2 and 137 patients were CKD stage 3 or higher. After PSM analysis using age, pre-treatment eGFR, and clinical tumor size as matching variables, the PN and RFA groups had 270 and 135 CKD stage 2 patients, respectively, and both had 53 patients each with CKD stage 3 or higher. There were no significant differences in percent change in eGFR at 1 year post-operation between groups in patients with CKD stage 2 and stage 3 or higher. Among all patients with tissue-proven malignancy, the 5-year recurrence-free survival (RFS), cancer-specific survival, and overall survival were significantly higher in the PN group. However, only the 5-year RFS was significantly higher in the PN group after matching. Conclusion: Mortality is low in patients with SRM, and functional outcomes were not significantly different between the two treatments. RFA could be an alternative treatment modality in patients who are poor candidates for surgery. MDPI 2022-09-23 /pmc/articles/PMC9600482/ /pubmed/36291981 http://dx.doi.org/10.3390/diagnostics12102292 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Ryoo, Hyunsoo Kang, Minyong Sung, Hyun Hwan Jeon, Hwang Gyun Jeong, Byong Chang Jeon, Seong Soo Lee, Hyun Moo Park, Byung Kwan Seo, Seong Il A Comparison of Functional and Oncologic Outcomes between Partial Nephrectomy and Radiofrequency Ablation in Patients with Chronic Kidney Disease after Propensity Score Matching |
title | A Comparison of Functional and Oncologic Outcomes between Partial Nephrectomy and Radiofrequency Ablation in Patients with Chronic Kidney Disease after Propensity Score Matching |
title_full | A Comparison of Functional and Oncologic Outcomes between Partial Nephrectomy and Radiofrequency Ablation in Patients with Chronic Kidney Disease after Propensity Score Matching |
title_fullStr | A Comparison of Functional and Oncologic Outcomes between Partial Nephrectomy and Radiofrequency Ablation in Patients with Chronic Kidney Disease after Propensity Score Matching |
title_full_unstemmed | A Comparison of Functional and Oncologic Outcomes between Partial Nephrectomy and Radiofrequency Ablation in Patients with Chronic Kidney Disease after Propensity Score Matching |
title_short | A Comparison of Functional and Oncologic Outcomes between Partial Nephrectomy and Radiofrequency Ablation in Patients with Chronic Kidney Disease after Propensity Score Matching |
title_sort | comparison of functional and oncologic outcomes between partial nephrectomy and radiofrequency ablation in patients with chronic kidney disease after propensity score matching |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9600482/ https://www.ncbi.nlm.nih.gov/pubmed/36291981 http://dx.doi.org/10.3390/diagnostics12102292 |
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