Comparison Of The Safety And Efficacy Of Cryoablation And Laparoscopic Partial Nephrectomy For T1a Renal Cell Carcinoma

Objective: To compare the safety and efficacy of cryoablation(CA) and laparoscopic partial nephrectomy(LPN) for T1 a renal cell carcinoma(RCC).Materials and Methods: We reviewed the clinical data of 25 cases who underwent CA and 98 cases who accepted LPN at our institution from July 1, 2012 to September 30, 2015, termed group CA and group LPN, respectively. Outcomes including renal function, estimated blood loss, operative time, length of hospital stay, complication rate, recurrence-free survival(RFS), metastasis-free survival(MFS) and overall survival(OS) of the two treatment methods were compared with chisquare test or t test.Results: In our cohort, age, tumor size and follow-up time were similar in group CA and group LPN(p>0.05 for all). The mean operative time, estimated blood loss and length of hospital stay for the two groups were 89.8 min versus 113.9 min, 40.8 ml versus 112.4 ml, 6.7 days versus 9.9 days, respectively. The difference was statistically significant(p<0.0001 for all). The increase of serum creatinine(s Cr) were 11.0% in group CA and 25.8% in group LPN after operation(p<0.0001). The decline of estimated glomerular filtration rate(e GFR) were 6.8% and 14.1%, respectively(p<0.0001). The complication rate were 16.0%(4/25) for CA and 18.4%(18/98) for LPN and they were similar(p=0.783). During the follow-up, in group LPN, there were 2 patients of local recurrence and 2 of lung metastasis, while there was no recurrence, metastasis and death for group CA. There was no difference in RFS(p=0.462), MFS(p=0.495) and OS between the two groups.Conclusions: In the cohort, we observed that CA and LPN were similarly safe and effective for T1 a renal cell carcinoma, while CA was superior to LPN in operative time, estimated blood loss, length of hospital stay and renal function preservation.