Limitations of Available Studies Prevent Reliable Comparison Between Tumour Ablation and Partial Nephrectomy for Patients with Localised Renal Masses: A Systematic Review from the European Association of Urology Renal Cell Cancer Guideline Panel

被引：56

作者：

Abu-Ghanem, Yasmin ^{[1
]}

Fernandez-Pello, Sergio ^{[2
]}

Bex, Axel ^{[3
,4
,5
]}

Ljungberg, Borje ^{[6
]}

Albiges, Laurence ^{[7
]}

Dabestani, Saeed ^{[8
]}

Giles, Rachel H. ^{[9
]}

Hofmann, Fabian ^{[10
]}

Hora, Milan ^{[11
,12
]}

Kuczyk, Markus A. ^{[13
]}

Kuusk, Teele ^{[14
]}

Marconi, Lorenzo ^{[15
]}

Merseburger, Axel S. ^{[16
]}

Tahbaz, Rana ^{[17
]}

Staehler, Michael ^{[18
]}

Volpe, Alessandro ^{[19
]}

Powles, Thomas ^{[14
]}

Lam, Thomas B. ^{[20
,21
,22
]}

Bensalah, Karim ^{[23
]}

机构：

[1] Chaim Sheba Med Ctr, Dept Urol, Ramat Gan, Israel

[2] Cabuenes Hosp, Dept Urol, Gijon, Spain

[3] Royal Free London NHS Fdn Trust, London, England

[4] UCL Div Surg & Intervent Sci, London, England

[5] Antoni van Leeuwenhoek Hosp, Netherlands Canc Inst, Dept Urol, Amsterdam, Netherlands

[6] Umea Univ, Dept Surg & Perioperat Sci Urol & Androl, Umea, Sweden

[7] Inst Gustave Roussy, Dept Canc Med, Villejuif, France

[8] Skane Univ Hosp, Dept Urol, Malmo, Sweden

[9] Univ Med Ctr Utrecht, Dept Nephrol & Hypertens, Patient Advocate Int Kidney Canc Coalit IKCC, Utrecht, Netherlands

[10] Sunderby Hosp, Dept Urol, Sunderby, Sweden

[11] Charles Univ Prague, Fac Hosp, Dept Urol, Prague, Czech Republic

[12] Charles Univ Prague, Fac Med Pilsen, Prague, Czech Republic

[13] Hannover Med Sch, Dept Urol & Urol Oncol, Hannover, Germany

[14] Royal Free Hosp, Dept Urol, London, England

[15] Coimbra Univ Hosp, Dept Urol, Coimbra, Portugal

[16] Univ Hosp Schleswig Holstein, Dept Urol, Lubeck, Germany

[17] Elbe Kliniken Stade, Dept Urol, Stade, Germany

[18] Ludwig Maximilians Univ Munchen, Dept Urol, Munich, Germany

[19] Univ Piemonte Orientale, Maggiore Carita Hosp, Div Urol, Novara, Italy

[20] Royal Free NHS Trust, London, England

[21] Queen Mary Univ London, Barts Canc Inst, London, England

[22] Univ Aberdeen, Acad Urol Unit, Aberdeen, Scotland

[23] Univ Rennes, Dept Urol, Rennes, France

来源：

EUROPEAN UROLOGY ONCOLOGY | 2020年 / 3卷 / 04期

关键词：

Renal cell cancer; Ablative therapy; Partial nephrectomy; Prognosis; European Association of Urology guidelines;

D O I：

10.1016/j.euo.2020.02.001

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

The European Association of Urology (EAU) Renal Cell Carcinoma (RCC) Guideline Panel performed a protocol-driven systematic review (SR) on thermal ablation (TA) compared with partial nephrectomy (PN) for T1N0M0 renal masses, in order to provide evidence to support its recommendations. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed, and only comparative studies published between 2000 and 2019 were included. Twenty-six nonrandomised comparative studies were included, recruiting a total of 167 80 patients. Risk of bias (RoB) assessment revealed high or uncertain RoB across all studies, with the vast majority being retrospective, observational studies with poorly matched controls and short follow-up. Limited data showed TA to be safe, but its long-term oncological effectiveness compared with PN remains uncertain. A quality assessment of pre-existing SRs (n = 11) on the topic, using AMSTAR, revealed that all SRs had low confidence rating, with all but two SRs being rated critically low. In conclusion, the current data are inadequate to make any strong and clear conclusions regarding the clinical effectiveness of TA for treating T1N0M0 renal masses compared with PN. Therefore, TA may be cautiously considered an alternative to PN for T1N0M0 renal masses, but patients must be counselled carefully regarding the prevailing uncertainties. We recommend specific steps to improve the evidence base based on robust primary and secondary studies. Patient summary: In this report, we looked at the literature to determine the effectiveness of thermoablation (TA) in the treatment of small kidney tumours compared with surgical removal. We found that TA could cautiously be offered as an option due to many remaining uncertainties regarding its effectiveness. (c) 2020 Published by Elsevier B.V. on behalf of European Association of Urology.

引用

页码：433 / 452

页数：20

共 14 条

[1] Current practice patterns in the use of ablation technology for the management of small renal masses at academic centers in the United States [J].

Bandi, Gaurav ;

Hedican, Sean P. ;

Nakada, Stephen Y. .

UROLOGY, 2008, 71 (01) :113-117

[2] Guideline for Management of the Clinical T1 Renal Mass [J].

Campbell, Steven C. ;

Novick, Andrew C. ;

Belldegrun, Arie ;

Blute, Michael L. ;

Chow, George K. ;

Derweesh, Ithaar H. ;

Faraday, Martha M. ;

Kaouk, Jihad H. ;

Leveillee, Raymond J. ;

Matin, Surena F. ;

Russo, Paul ;

Uzzo, Robert G. .

JOURNAL OF UROLOGY, 2009, 182 (04) :1271-1279

[3] Management of Sporadic Renal Angiomyolipomas: A Systematic Review of Available Evidence to Guide Recommendations from the European Association of Urology Renal Cell Carcinoma Guidelines Panel [J].

Fernandez-Pello, Sergio ;

Hora, Milan ;

Kuusk, Teele ;

Tahbaz, Rana ;

Dabestani, Saeed ;

Abu-Ghanem, Yasmin ;

Albiges, Laurence ;

Giles, Rachel H. ;

Hofmann, Fabian ;

Kuczyk, Markus A. ;

Lam, Thomas B. ;

Marconi, Lorenzo ;

Merseburger, Axel S. ;

Powles, Thomas ;

Staehler, Michael ;

Volpe, Alessandro ;

Ljungberg, Borje ;

Bex, Axel ;

Bensalah, Karim .

EUROPEAN UROLOGY ONCOLOGY, 2020, 3 (01) :57-72

[4]

Guazzoni G, 2010, UROLOGY, V76, P624, DOI 10.1016/j.urology.2010.03.078

[5] Tumour in solitary kidney: laparoscopic partial nephrectomy vs laparoscopic cryoablation [J].

Haber, Georges-Pascal ;

Lee, Michael C. ;

Crouzet, Sebastien ;

Kamoi, Kazumi ;

Gill, Inderbir S. .

BJU INTERNATIONAL, 2012, 109 (01) :118-124

[6] Long-term oncologic outcomes of laparoscopic renal cryoablation as primary treatment for small renal masses [J].

Larcher, Alessandro ;

Fossati, Nicola ;

Mistretta, Francesco ;

Lughezzani, Giovanni ;

Lista, Giuliana ;

Dell'Oglio, Paolo ;

Abrate, Alberto ;

Sun, Maxine ;

Karakiewicz, Pierre ;

Suardi, Nazareno ;

Lazzeri, Massimo ;

Montorsi, Francesco ;

Guazzoni, Giorgio ;

Buffi, Nicolo .

UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS, 2015, 33 (01) :22.e1-22.e9

[7] Partial nephrectomy versus ablative therapy for the treatment of renal tumors in an imperative setting [J].

Long, Jean-Alexandre ;

Bernhard, Jean-Christophe ;

Bigot, Pierre ;

Lanchon, Cecilia ;

Paparel, Philippe ;

Rioux-Leclercq, Nathalie ;

Albiges, Laurence ;

Bodin, Thomas ;

Nouhaud, Francois-Xavier ;

Boissier, Romain ;

Gimel, Pierre ;

Mejean, Arnaud ;

Masson-Lecomte, Alexandra ;

Grenier, Nicolas ;

Cornelis, Francois ;

Grassano, Yohann ;

Comat, Vincent ;

Le Clerc, Quentin Come ;

Rigaud, Jerome ;

Salomon, Laurent ;

Descotes, Jean-Luc ;

Sengel, Christian ;

Roupret, Morgan ;

Verhoest, Gregory ;

Ouzaid, Idir ;

Arnoux, Valentin ;

Bensalah, Karim .

WORLD JOURNAL OF UROLOGY, 2017, 35 (04) :649-656

[8] Surgical Innovation and Evaluation 3 No surgical innovation without evaluation: the IDEAL recommendations [J].

McCulloch, Peter ;

Altman, Douglas G. ;

Campbell, W. Bruce ;

Flum, David R. ;

Glasziou, Paul ;

Marshall, John C. ;

Nicholl, Jon .

LANCET, 2009, 374 (9695) :1105-1112

[9]

Moher D, 2015, SYST REV-LONDON, V4, DOI [10.1371/journal.pmed.1000097, 10.1186/2046-4053-4-1, 10.1136/bmj.i4086, 10.1016/j.ijsu.2010.02.007, 10.1136/bmj.b2700, 10.1016/j.ijsu.2010.07.299, 10.1136/bmj.b2535]

[10] Protocol for a feasibility study of a cohort embedded randomised controlled trial comparing NEphron Sparing Treatment (NEST) for small renal masses [J].

Neves, Joana B. ;

Cullen, David ;

Grant, Lee ;

Walkden, Miles ;

Bandula, Steve ;

Patki, Prasad ;

Barod, Ravi ;

Mumtaz, Faiz ;

Aitchison, Michael ;

Pizzo, Elena ;

Ranieri, Veronica ;

Williams, Norman ;

Wildgoose, William ;

Gurusamy, Kurinchi ;

Emberton, Mark ;

Bex, Axel ;

Tran, Maxine G. B. .

BMJ OPEN, 2019, 9 (06)

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