Ablation as effective as surgery for certain kidney cancers
A simple interventional procedure is as effective as surgery for small kidney cancers, according to research published Tuesday in Radiology.
Stage T1a renal cell carcinoma is often found incidentally on CT scans performed for other clinical indications. Typically, these cancers are treated via surgical resection, but ablative techniques have gained recognition in recent years due to them being less invasive in nature. Ablation also comes with the benefit of lower risk of complications and fewer costs.
“These incidental cancers are putting increasing pressure on healthcare systems,” said lead author Iben Lyskjær, PhD, associate professor at Aarhus University and Aarhus Hospital in Denmark. “While early detection improves outcomes, it also raises the need for better risk stratification and treatment options.”
Lyskjær and colleagues recently reviewed a national database housing information on Danish adults who were diagnosed with T1a renal cell carcinoma between January 2013 and December 2021. The team compared how treatment methods—either surgery or some type of ablation—affected patient outcomes, including instances of recurrence and metastases.
Of the nearly 2,000 cases studied, 540 underwent either cryo- or radiofrequency ablation, while 1,002 were in the resection group and another 320 had a full or partial nephrectomy. In the ablation group, just 42 underwent radiofrequency ablation.
The risk of cancer progression was similar between all groups, though local recurrence was more common among those who underwent an ablative procedure compared to those in the resection and nephrectomy groups (2.41%, 1.20%, and 0%). Lyskjær noted, however, that local disease recurrence can be effectively treated with an additional ablation.
Rates of distant metastases were lowest among the ablation group, at 1.67%; in comparison, distant metastases were calculated at 4.38% and 1.9% in the nephrectomy and resection groups. What’s more, hospital stays were lowest in the ablation group, with most patients returning home the same day as their procedure. Resection and nephrectomy, on the other hand, typically were accompanied by a two-day hospital stay.
Each treatment positively affected patient outcomes. Lyskjaer said, for this reason, the decision regarding which method is most appropriate ultimately comes down to individual patient characteristics and preference, but ablation is a promising option for individuals who are not candidates for more invasive surgeries.
“We should be showing patients data and asking the patients what kind of treatment they want,” Lyskjær suggested.
The study abstract is available here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.