Perioperative functional and oncologic outcomes of percutaneous thermal ablation (PTA) versus robot-assisted partial...

There is ongoing debate on the relative safety and effectiveness of robot-assisted partial nephrectomy (RAPN) and percutaneous thermal ablation (PTA) in the treatment of cT1 renal cancers. The purpose of this study was to compare the oncological, functional, and perioperative results of these two approaches. Web of Science, PubMed, Cochrane Library, and EMBASE were used in a systematic review to find English-language research that was published before to August 2025. Review Manager 5.4 was used to do a meta-analysis, combining five trials with 773 patients (398 treated with PTA and 375 with RAPN). Weighted mean differences (WMD) were utilized for continuous variables, while odds ratios (OR) were used for dichotomous variables. PROSPERO registered the study (ID: CRD420251125197). PTA was associated to a reduced postoperative glomerular filtration rate (WMD: -14.14; 95% CI: -23.77 to -4.15; P = 0.004), a higher local recurrence rate (OR: 4.14; 95% CI: 1.63-10.53; P = 0.003), and a significantly shorter operative time (WMD: -86.41 min; 95% CI: -143.58 to -29.24; P = 0.003) when compared to RAPN. The duration of hospital stays, the rate of postoperative glomerular filtration rate drop, serious complications (Clavien-Dindo grade ≥ III), the risk of metastases, and 5-year overall survival (OS) did not, however, differ significantly between the two groups. According to our research, PTA and RAPN are both safe and efficient ways to treat cT1 renal tumors while maintaining a similar level of renal function. For individuals with pre-existing renal impairment or poor overall health, PTA could be a better option.