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Kaohsiung J Med Sci · Dec 2015
Review Meta Analysis Comparative StudyRadiofrequency ablation versus partial nephrectomy for treatment of renal masses: A systematic review and meta-analysis.
- Xiu-Wu Pan, Xin-Ming Cui, Hai Huang, Yi Huang, Lin Li, Zhi-Jun Wang, Fa-Jun Qu, Yi Gao, Xin-Gang Cui, and Dan-Feng Xu.
- Department of Urologic Surgery, Changzheng Hospital of the Second Military Medical University, Shanghai, China; Department of Urologic Surgery, Third Affiliated Hospital of the Second Military Medical University, Shanghai, China.
- Kaohsiung J Med Sci. 2015 Dec 1; 31 (12): 649-58.
AbstractOur study was to collect the data available in the literature on radiofrequency ablation (RFA) and partial nephrectomy (PN) and conduct a cumulative analysis on perioperative outcomes, renal function outcomes, and survival to evaluate the overall safety and efficacy of RFA versus PN for small renal cell cancer (SRCC). A literature search was carried out using various electronic databases. Data including age, tumor size, comorbid disease, operation duration, hospital stay, pre- and postoperative estimated glomerular filtration rate (eGFR), major and minor complications, and local tumor recurrence and metastasis were collected for meta-analysis. Sixteen studies were included for this meta-analysis. The age of patients treated with RFA was significantly older than that of patients treated with PN [weighted mean difference (WMD) = 5.07 years]. There were more patients with cardiovascular disease in RFA group as compared with PN group [odds ratio (OR) = 4.24] before treatment. RFA was associated with a shorter length of hospital stay compared with PN (WMD = -2.02 days). No significant difference was found in major and minor complications between the two groups (major: OR = 0.74; minor: OR = 0.45). Preoperative eGFR and eGFR decline in RFA patients was significantly lower than that in PN patients (WMD = -7.27 and -4.82, respectively), whereas there was no significant difference in postoperative eGFR (WMD = -1.18). The local tumor recurrence rate in RFA group was higher than that in PN group (OR = 1.81). However, the distant metastasis rate was no statistical difference between the two groups (OR = 1.63). RFA is a suitable therapeutic option for older patients and those at high risk for SRCC because of a low risk of operation and better preservation of renal function. Copyright © 2015. Published by Elsevier Taiwan.
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