NEW YORK (Reuters Health) Dec 19 - When minimally invasive therapy is elected for small renal masses, cryoablation may have advantages over radiofrequency ablation (RFA), according to meta-analysis of data from 47 studies.
The co-authors of the analysis point out that surgical resection remains the standard of care. Still, as investigator Dr. Robert G. Uzzo told Reuters Health, the meta-analysis "provides a cumulative snapshot of the efficacy and shortcomings of ablation in lieu of resection -- or excision -- for small localized renal masses and demonstrates that there is a tradeoff when it comes to ablation, such that pathology is frequently unknown, retreatment is not uncommon and only short term oncologic outcomes exist."
In the November 15 issue of Cancer, Dr. Uzzo and Dr. David A. Kunkle, both at Temple University School of Medicine in Philadelphia, report that the included studies involved 1375 kidney lesions treated with cryoablation or RFA.
Patients treated with RFA had a higher frequency of unknown pathology (40.4%, vs 24.5% with cryoablation), higher rate of repeat ablation (8.5%, vs 1.3% with cryoablation), higher rate of local tumor progression (12.9%, vs 5.2% with cryoablation), and more frequent reports of metastasis (2.5%, vs 1.0% with cryoablation).
Thus, continued Dr. Uzzo, "RFA appears to be associated with a higher risk of local persistence and/or recurrence compared to cryoablation, which may be a function of the application of the technology or the technology itself."
"Extended oncologic efficacy remains to be established for ablation modalities," the researchers conclude. "Among ablation modalities, data suggest that cryoablation may result in significantly lower rates of local tumor progression compared with RFA."
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