Renal functional outcomes after robot-assisted partial nephrectomy and percutaneous cryoablation of clinical T1 renal cell carcinoma - A prospective study

机器人辅助部分肾切除术联合经皮冷冻消融治疗临床T1期肾细胞癌后的肾功能预后——一项前瞻性研究

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Abstract

OBJECTIVES: The objective of this study was to investigate renal function after robot-assisted partial nephrectomy (RAPN) and percutaneous cryoablation (PCA) in clinical stage T1 (cT1) renal cell carcinoma (RCC) and evaluate the relationship between baseline renal function and renal functional outcome. MATERIAL AND METHODS: Patients with cT1 RCC treated with RAPN or PCA were prospectively enrolled between June 2019 and January 2021. Renal function was evaluated using estimated glomerular filtration rate, Tc-99m diethylenetriamine-pentaacetate plasma clearance, Tc-99m mercaptoacetyltriglycine renography, and renal volume at baseline and 6 months after treatment. RESULTS: Fifty-six patients were included (18 RAPN, 38 PCA). PCA patients had a significantly higher age (68.5 years; P = 0.019) and Charlson comorbidity index (3.0; P = 0.007). Tumor characteristics did not differ significantly between RAPN and PCA. Total renal volume decreased significantly after PCA (-18.2 cm(3); P = 0.001). Baseline chronic disease stage IIIb-IV leads to a greater reduction in renal volume (-31.8 cm(3); P = 0.003) but not other renal function measures. Renal function declined significantly after either treatment without significant differences between RAPN and PCA. CONCLUSION: This study found a small, similar decrease in renal function 6 months after RAPN or PCA, despite significant differences in baseline patient characteristics. Reduced renal function at baseline did not lead to a worse renal functional outcome.

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