Cryoablation is associated with worse cancer-specific survival compared with partial nephrectomy (PN) for pT1b nonmetastatic renal cell carcinoma (nmRCC), new data suggest.

Using the Surveillance, Epidemiology, and End Results database (2004-2015), Angela Pecoraro, MD, of the University of Montreal Health Center in Canada, and colleagues identified 5763 patients with pT1b nmRCC treated with cryoablation (242 patients) or PN (5521 patients). The cryoablation group was older and had smaller tumor size compared with the PN group.

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The median follow-up was 38 months. After propensity score matching and adjustment for other-cause mortality (OCM), the 5-year cancer-specific mortality (CSM) rate was 2.5-fold higher following cryoablation than PN, Dr Pecoraro’s team reported in the Journal of Urology. “This observation should be interpreted as a contraindication to cryoablation outside of clinical trials or institutional protocols,” the authors concluded.

After PS matching and CSM adjustment, the 5-year OCM rates for PN and cryoablation were similar, the investigators reported.

Reference

Pecoraro A, Palumbo C, Knipper S, et al. In non-metastatic pT1b kidney cancer patients cryoablation predisposes to higher cancer specific mortality relative to partial nephrectomy.  J Urol. 2019. doi: 10.1097/JU.0000000000000460