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Impact of Partial Nephrectomy and Percutaneous Cryoablation on Short-term Health-related Quality of Life—A Prospective Comparative Cohort Study

BACKGROUND: Partial nephrectomy (PN) is the gold standard for the treatment of stage cT1 renal cell carcinoma (RCC). However, the increasing incidence of RCC in the elderly population calls for alternative minimally invasive treatments to reduce the negative effects on patients’ health-related quali...

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Autores principales: Junker, Theresa, Duus, Louise, Rasmussen, Benjamin S.B., Azawi, Nessn, Lund, Lars, Nørgaard, Birgitte, Graumann, Ole
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9637566/
https://www.ncbi.nlm.nih.gov/pubmed/36353658
http://dx.doi.org/10.1016/j.euros.2022.09.013
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author Junker, Theresa
Duus, Louise
Rasmussen, Benjamin S.B.
Azawi, Nessn
Lund, Lars
Nørgaard, Birgitte
Graumann, Ole
author_facet Junker, Theresa
Duus, Louise
Rasmussen, Benjamin S.B.
Azawi, Nessn
Lund, Lars
Nørgaard, Birgitte
Graumann, Ole
author_sort Junker, Theresa
collection PubMed
description BACKGROUND: Partial nephrectomy (PN) is the gold standard for the treatment of stage cT1 renal cell carcinoma (RCC). However, the increasing incidence of RCC in the elderly population calls for alternative minimally invasive treatments to reduce the negative effects on patients’ health-related quality of life (HRQoL) and subsequent healthy life expectancy. OBJECTIVE: To assess and compare short-term HRQoL and self-reported health status after PN and percutaneous cryoablation (PCA) of patients treated for RCC stage cT1. DESIGN, SETTING, AND PARTICIPANTS: Patients who underwent PN or PCA between 2019 and 2021 for RCC stage cT1 at two university hospitals in Denmark were assessed. The exclusion criteria included insufficient understanding of the Danish language, dementia, metastatic RCC, conversion to nephrectomy, and salvage procedures. INTERVENTION: PN and PCA. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire was distributed before treatment, and 14 and 90 d postoperatively. A linear mixed-effect model was used to analyze the changes from baseline to follow-up between PN and PCA treatment. RESULTS AND LIMITATIONS: The cohort included 165 patients (PN: 79; PCA: 86). The completion rate was 96–98%. Patients receiving PCA were significantly older (median 69.1 vs 62.1 yr) and had lower scores on physical (p < 0.001) and role functioning (p = 0.009) than PN. A statistically significant change from baseline to 14 d was found for several HRQoL scales, which favored PCA over PN. However, the observed change was no longer significant at 90-d follow-up. Limitations include sample size and confounding by indication. CONCLUSIONS: This study found a significant difference between baseline and 14-d follow-up in several HRQoL and symptoms scales, favoring PCA over PN. However, no significant differences were observed in any HRQoL scales between PN and PCA of RCC stage cT1 from baseline to 90-d follow-up. PATIENT SUMMARY: Surgical removal and percutaneous cryoablation (freezing) of small tumors in the kidney had a similar impact on quality of life after 90 d.
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spelling pubmed-96375662022-11-08 Impact of Partial Nephrectomy and Percutaneous Cryoablation on Short-term Health-related Quality of Life—A Prospective Comparative Cohort Study Junker, Theresa Duus, Louise Rasmussen, Benjamin S.B. Azawi, Nessn Lund, Lars Nørgaard, Birgitte Graumann, Ole Eur Urol Open Sci Kidney Cancer BACKGROUND: Partial nephrectomy (PN) is the gold standard for the treatment of stage cT1 renal cell carcinoma (RCC). However, the increasing incidence of RCC in the elderly population calls for alternative minimally invasive treatments to reduce the negative effects on patients’ health-related quality of life (HRQoL) and subsequent healthy life expectancy. OBJECTIVE: To assess and compare short-term HRQoL and self-reported health status after PN and percutaneous cryoablation (PCA) of patients treated for RCC stage cT1. DESIGN, SETTING, AND PARTICIPANTS: Patients who underwent PN or PCA between 2019 and 2021 for RCC stage cT1 at two university hospitals in Denmark were assessed. The exclusion criteria included insufficient understanding of the Danish language, dementia, metastatic RCC, conversion to nephrectomy, and salvage procedures. INTERVENTION: PN and PCA. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire was distributed before treatment, and 14 and 90 d postoperatively. A linear mixed-effect model was used to analyze the changes from baseline to follow-up between PN and PCA treatment. RESULTS AND LIMITATIONS: The cohort included 165 patients (PN: 79; PCA: 86). The completion rate was 96–98%. Patients receiving PCA were significantly older (median 69.1 vs 62.1 yr) and had lower scores on physical (p < 0.001) and role functioning (p = 0.009) than PN. A statistically significant change from baseline to 14 d was found for several HRQoL scales, which favored PCA over PN. However, the observed change was no longer significant at 90-d follow-up. Limitations include sample size and confounding by indication. CONCLUSIONS: This study found a significant difference between baseline and 14-d follow-up in several HRQoL and symptoms scales, favoring PCA over PN. However, no significant differences were observed in any HRQoL scales between PN and PCA of RCC stage cT1 from baseline to 90-d follow-up. PATIENT SUMMARY: Surgical removal and percutaneous cryoablation (freezing) of small tumors in the kidney had a similar impact on quality of life after 90 d. Elsevier 2022-10-17 /pmc/articles/PMC9637566/ /pubmed/36353658 http://dx.doi.org/10.1016/j.euros.2022.09.013 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Kidney Cancer
Junker, Theresa
Duus, Louise
Rasmussen, Benjamin S.B.
Azawi, Nessn
Lund, Lars
Nørgaard, Birgitte
Graumann, Ole
Impact of Partial Nephrectomy and Percutaneous Cryoablation on Short-term Health-related Quality of Life—A Prospective Comparative Cohort Study
title Impact of Partial Nephrectomy and Percutaneous Cryoablation on Short-term Health-related Quality of Life—A Prospective Comparative Cohort Study
title_full Impact of Partial Nephrectomy and Percutaneous Cryoablation on Short-term Health-related Quality of Life—A Prospective Comparative Cohort Study
title_fullStr Impact of Partial Nephrectomy and Percutaneous Cryoablation on Short-term Health-related Quality of Life—A Prospective Comparative Cohort Study
title_full_unstemmed Impact of Partial Nephrectomy and Percutaneous Cryoablation on Short-term Health-related Quality of Life—A Prospective Comparative Cohort Study
title_short Impact of Partial Nephrectomy and Percutaneous Cryoablation on Short-term Health-related Quality of Life—A Prospective Comparative Cohort Study
title_sort impact of partial nephrectomy and percutaneous cryoablation on short-term health-related quality of life—a prospective comparative cohort study
topic Kidney Cancer
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9637566/
https://www.ncbi.nlm.nih.gov/pubmed/36353658
http://dx.doi.org/10.1016/j.euros.2022.09.013
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