Midterm results of radiofrequency ablation versus nephrectomy for T1a renal cell carcinoma

The aim of this study was to retrospectively evaluate midterm results of renal radiofrequency (RF) ablation compared to the results after nephrectomy in patients with T1a renal cell carcinoma (RCC). A total of 115 patients with a single RCC measuring a parts per thousand currency sign4 cm (T1a) were included; 51 patients underwent RF ablation, 54 patients radical nephrectomy, and 10 patients partial nephrectomy. The survival and the percent decreases in glomerular filtration rate (GFR) were compared among the three treatments. Although overall survival after RF ablation (75.0% at 5 years) was lower than those after radical and partial nephrectomy, the RCC-related survival (100% at 5 years) was comparable to those following radical nephrectomy (100% at 5 years) and partial nephrectomy (100% at 3 years). The disease-free survival (DFS) after RF ablation (98.0% at 5 years) was also comparable to those after radical nephrectomy (95.0% at 5 years) (P = 0.72) and partial nephrectomy (75.0% at 3 years) (P = 0.13). The percent decrease in the GFR at last follow-up in the RF ablation group (median 7.9%) was significantly lower than that in the radical nephrectomy group (median 29.0%) (P < 0.001) and comparable to that in the partial nephrectomy group (median 11.5%) (P = 0.73). RF ablation provides RCC-related and DFS comparable to that found after nephrectomy with little loss of renal function.