Related Experiment Video

Updated: Jan 25, 2026

In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses

In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses

Published on: March 30, 2015

Oncologic Outcomes Following Partial Nephrectomy and Percutaneous Ablation for cT1 Renal Masses

Jack R Andrews¹, Thomas Atwell², Grant Schmit²

¹Department of Urology, Mayo Clinic and Mayo Medical School, Rochester, MN, USA.

European Urology

|May 8, 2019

Abstract

Background:

Long-term data comparing partial nephrectomy (PN) and thermal ablation are lacking.

Objective:

To update our experience with PN, percutaneous radiofrequency ablation (RFA), and percutaneous cryoablation for cT1 renal masses.

Design, Setting, And Participants:

A total of 1798 patients with primary cT1N0M0 renal masses treated between 2000 and 2011 at Mayo Clinic were identified.

Intervention:

Percutaneous ablation versus PN.

Outcome Measurements And Statistical Analysis:

Cancer-specific survival (CSS) was estimated using the Kaplan-Meier method. Local recurrence, metastases, and death from renal cell carcinoma (RCC) were compared with propensity-score-adjusted Cox models.

Results And Limitations:

Among 1422 cT1a patients, 1055, 180, and 187 underwent PN, RFA, and cryoablation with median clinical follow-up of 9.4, 7.5, and 6.3yr, respectively. Comparisons of RFA with PN resulted in hazard ratios (HRs) of 1.49 (95% confidence interval [CI] 0.55-4.04, p=0.4), 1.46 (95% CI 0.41-5.19, p=0.6), and 1.99 (95% CI 0.29-13.56, p=0.5) for local recurrence, metastases, and death from RCC. Comparisons of cryoablation to PN resulted in HRs of 1.88 (95% CI 0.76-4.66, p=0.18), 0.23 (95% CI 0.03-1.72, p=0.15), and 0.29 (95% CI 0.01-6.11, p=0.4) for these same outcomes. Five-year CSS was 99%, 96%, and 100% for PN, RFA, and cryoablation, respectively. Among 376 cT1b patients, 324 and 52 underwent PN and cryoablation with median clinical follow-up of 8.7 and 6.0yr, respectively. Comparisons of cryoablation with PN resulted in HRs of 1.22 (95% CI 0.33-4.48, p=0.8), 0.95 (95% CI 0.21-4.38, p>0.9), and 1.94 (95% CI 0.42-8.96, p=0.4) for local recurrence, metastases, and death from RCC, respectively. Five-year CSS was 98% and 91% for PN and cryoablation, respectively. Limitations include retrospective review and selection bias.

Conclusions:

With mature follow-up at a single institution, percutaneous ablation appears to have acceptable results for cT1 renal tumors and is appropriate for patients with a contraindication for surgery. For cT1a patients, clinically relevant differences between PN and ablation are unlikely, and treatment choice should involve shared decision making. For cT1b patients, death from RCC was more common with cryoablation, and large differences in this outcome cannot be ruled out. Further research is needed to confirm the oncologic effectiveness of cryoablation in the cT1b setting.

Patient Summary:

With appropriate patient triage, partial nephrectomy and percutaneous ablation can be used to treat cT1 renal masses, although additional follow-up and further study are still needed.

Keywords:

Ablation techniques Cryosurgery Kidney neoplasms Partial nephrectomy Thermal ablation

More Related Videos

Application of Microwave Ablation in Laparoscopic Partial Splenectomy

Application of Microwave Ablation in Laparoscopic Partial Splenectomy

Published on: November 15, 2024

Modeling Spontaneous Metastatic Renal Cell Carcinoma mRCC in Mice Following Nephrectomy

Modeling Spontaneous Metastatic Renal Cell Carcinoma mRCC in Mice Following Nephrectomy

Published on: April 29, 2014

Related Concept Videos

Predicting Reaction Outcomes

Predicting Reaction Outcomes

Kinetics describes the rate and path by which a reaction occurs. In contrast, thermodynamics deals with state functions and describes the properties, behavior, and components of a system. It is not concerned with the path taken by the process and cannot address the rate at which a reaction occurs. Although it does provide information about what can happen during a reaction process, it does not describe the detailed steps of what appears on an atomic or a molecular level. On the other hand,...

Outcomes of Glycolysis

Outcomes of Glycolysis

Nearly all the energy used by cells comes from the bonds that make up complex organic compounds. These organic compounds are broken down into simpler molecules, such as glucose. As a result, cells extract energy from glucose over many chemical reactions—a process called cellular respiration.
Cellular respiration can occur aerobically (with oxygen) or anaerobically (without oxygen). In the presence of oxygen, cellular respiration starts with glycolysis and continues with pyruvate...

Factors Affecting Renal Clearance: Renal Impairment

Factors Affecting Renal Clearance: Renal Impairment

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...

Guidelines for Writing Outcome

Guidelines for Writing Outcome

When developing expected outcomes for a patient care plan, the nurse should adhere to the following recommendations:
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...

Mixtures of Gases: Dalton's Law of Partial Pressures and Mole Fractions

Mixtures of Gases: Dalton's Law of Partial Pressures and Mole Fractions

Unless individual gases chemically react with each other, the individual gases in a mixture of gases do not affect each other’s pressure. Each gas in a mixture exerts the same pressure that it would exert if it were present alone in the container. The pressure exerted by each individual gas in a mixture is called its partial pressure.

Atomic Mass

Atomic Mass

Atoms — and the protons, neutrons, and electrons that compose them — are extremely small. For example, a carbon atom weighs less than 2 × 10−23 g. When describing the properties of tiny objects such as atoms, we use appropriately small units of measure, such as the atomic mass unit (amu). The amu was originally defined based on hydrogen, the lightest element, then later in terms of oxygen. Since 1961, it has been defined with regard to the most abundant isotope of carbon, atoms of which...

Articles linked to this work by shared authors, journal, and citation graph.

Predicting Complications After Radical Nephrectomy With Venous Tumor Thrombectomy and Various IVC Reconstruction Approaches: A Simplified Risk Calculator.

Urology·2026

Pancreatic resection for metastatic renal cell carcinoma: outcomes in the era of immunotherapy and targeted therapy.

HPB : the official journal of the International Hepato Pancreato Biliary Association·2026

Whole-proteome phage immunoprecipitation sequencing reveals germ cell tumor-specific immunosignature.

Nature communications·2026

Utility of Next-Generation Sequencing in Renal Neoplasia, Including Tumors With Clear Cytoplasm and Rare Phenotypes (ELOC/MITF Alterations and Mismatch Repair Deficiency).

Mayo Clinic proceedings·2026

A Simplified Prediction Tool for Metastasis After Nephrectomy With Venous Tumor Thrombectomy for RCC.

Urology·2026

Growth Kinetics of Venous Tumor Thrombus From Renal Cell Carcinoma.

The Journal of urology·2025

See all related articles