Partial Nephrectomy versus Percutaneous Cryoablation of Small Renal Cell Carcinomas: A Comparison of Adverse Events in a Prospective Multicenter Cohort Study

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  • Theresa Junker
  • Louise Duus
  • Benjamin S.B. Rasmussen
  • Azawi, Nessn H.
  • Lars Lund
  • Birgitte Nørgaard
  • Oke Gerke
  • Ole Graumann

Purpose: To assess and compare complications and readmissions after partial nephrectomy and percutaneous cryoablation of cT1 renal cell carcinoma (RCC). Materials and Methods: Patients treated for cT1 RCC between 2019 and 2021 were prospectively and consecutively enrolled. Complications recorded within 30 and 90 days were graded according to the Clavien-Dindo classification, and percutaneous cryoablation was graded according to the Society of Interventional Radiology classification of adverse events. Major complications were defined as complications with a grade of ≥3 based on the Clavien-Dindo classification. Readmission within 30 days was recorded. Results: The cohort included 86 partial nephrectomies and 104 cryoablations. The complication rate within 90 days was 23% after partial nephrectomy and cryoablation (P = .98), with major complication rates of 3% after partial nephrectomy and 10% after cryoablation (P = .15). The readmission rates were 14% and 11% after partial nephrectomy and cryoablation, respectively (P = .48). Double-J stents were associated with overall complications (odds ratio [OR], 9.88; 95% confidence interval [CI], 2.18–44.68; P = .003) and readmissions (OR, 5.39; 95% CI, 1.37–21.06; P = .015) after cryoablation. A high versus low radius-endophytic-nearness-anterior-location score (OR, 5.86; 95% CI, 1.08–31.81; P = .040) and endophytic location (OR, 7.70; 95% CI, 1.72–34.50; P = .008) were associated with a higher complication rate after cryoablation. The Charlson Comorbidity Index (CCI) was associated with major complications after partial nephrectomy (OR, 2.12; 95% CI, 1.05–4.30; P = .036). Conclusions: Partial nephrectomy and cryoablation are comparable regarding complications within 90 days after treatment. Tumor complexity and double-J stents were associated with complications after cryoablation, and a high CCI was associated with complications after partial nephrectomy.

OriginalsprogEngelsk
TidsskriftJournal of Vascular and Interventional Radiology
Vol/bind33
Udgave nummer11
Sider (fra-til)1375-1383.e7
ISSN1051-0443
DOI
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
T.J. reports research grant from Boston Scientific . O.Gr. reports research grant and speaker honoraria from Boston Scientific and is an Advisor Board Member of Boston Scientific . The other authors have not identified a conflict of interest.

Publisher Copyright:
© 2022 SIR

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