Is Ablation Suitable For Small Renal Masses? A Meta-Analysis

Area of Science:

• Urology
• Oncology
• Surgical Outcomes

Background:

• Small renal masses (SRMs) are increasingly detected, necessitating a comparison of treatment modalities.
• Partial nephrectomy and ablation are common surgical options for SRMs.
• Evaluating perioperative and oncologic outcomes is crucial for guiding treatment decisions.

Purpose of the Study:

• To compare the perioperative and oncology outcomes of ablation versus partial nephrectomy for small renal masses (SRMs).

Main Methods:

• A systematic meta-analysis was conducted following PRISMA standards.
• Data were extracted from Embase, PubMed, Cochrane Library, and Web of Science up to November 2023.
• Statistical analysis included weighted mean difference (WMD) and odds ratio (OR/RR) with 95% confidence intervals (95%CI).

Main Results:

• Partial nephrectomy patients were younger, had longer operation times, longer hospital stays, and greater blood loss.
• Overall and major complication rates were higher with partial nephrectomy (OR = 1.84, OR = 1.98).
• Recurrence rates were lower with partial nephrectomy (OR = 0.32), but no significant differences were found in cancer-specific survival (CSS), overall survival (OS), or recurrence-free survival (RFS).

Conclusions:

• Partial nephrectomy for SRMs is associated with increased perioperative morbidity compared to ablation.
• Oncologic outcomes, including CSS, OS, and RFS, did not significantly differ between the two treatments.
• Further high-quality studies are warranted to confirm these findings.