Comparison of radiofrequency ablation and partial nephrectomy for tumor in a solitary kidney.

BACKGROUND: To estimate oncologic and functional outcomes for radiofrequency ablation (RFA) versus partial nephrectomy (PN) for tumors in a solitary kidney.

METHODS: Nineteen patients with sporadic renal cell carcinoma in a solitary kidney were treated with RFA, and 21 patients were treated with PN between November 2008 and September 2015. Basic demographic information including age, gender, operative and pathological data, complications, renal function, oncological outcomes, was obtained for each patient. Statistical analysis was done to test for the correlation of clinical and pathological features, renal function outcomes, as well as oncological outcomes of RFA and PN. All statistical tests were 2-sided, and p-value < 0.05 was considered significant. Statistical analyses were performed using SPSS 19.0.

RESULTS: No significant differences were indicated between the RFA and PN with respect to mean patient age, tumor size, as well as intraoperative or postoperative complications. The mean length of hospitalization (P = 0.019) and mean operative time (P = 0.036) was significantly shorter in RFA, with the median estimated blood loss being greater in PN (P = 0.001). The mean serum creatinine level 24 h following operation were significantly higher than preoperative creatinine in PN (P = 0.009), but did not reach statistical significance in RFA. Local recurrence were detected in only 1 patient (5%) in PN and 3 patients (18.75%) in RFA (P = 0.4). One patient developed pulmonary metastasis and one exhibited tumor persistence in RFA, none were present in PN.

CONCLUSIONS: Radiofrequency Ablation and Partial Nephrectomy for Tumors in a Solitary Kidney were all safe and effective, with each method having distinct advantages. It is the decision of the patient and urologist to pick the best approach.