scholarly journals Renal Function Loss After Cryoablation of Small Renal Masses in Solitary Kidneys: European Registry for Renal Cryoablation Multi-Institutional Study

2020 ◽  
Vol 34 (2) ◽  
pp. 233-239 ◽  
Author(s):  
Seshadri Sriprasad ◽  
Mohammed Aldiwani ◽  
Shiv Pandian ◽  
Tommy K. Nielsen ◽  
Mohamed Ismail ◽  
...  
Keyword(s):  
Renal Function ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Function Loss ◽  
European Registry

509 IS BASELINE RENAL FUNCTION A DECISION-MAKING CRITERION FOR CHOOSING AN ABLATIVE TECHNIQUE RATHER THAN A PARTIAL NEPHRECTOMY IN SMALL RENAL MASSES?

2010 ◽  
Vol 183 (4S) ◽  
Author(s):  
Pierre Bigot ◽  
Maxime Crepel ◽  
Gregory Verhoest ◽  
Karim Bensalah ◽  
Alexandre De La Taille ◽  
...  
Keyword(s):  
Decision Making ◽  
Renal Function ◽  
Partial Nephrectomy ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Baseline Renal Function

scholarly journals Is There a Role for Neoadjuvant Targeted Therapy to Downsize Primary Tumors for Organ Sparing Strategies in Renal Cell Carcinoma?

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
A. Bex ◽  
B. K. Kroon ◽  
R. de Bruijn
Keyword(s):  
Renal Function ◽  
Targeted Therapy ◽  
Treatment Strategies ◽  
Clinical Problem ◽  
Current Evidence ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Primary Tumors ◽  
Risk Of Death ◽  
Nephron Sparing

With an increasing number of small renal masses being diagnosed organ-preserving treatment strategies such as nephron-sparing surgery (NSS) or radiofrequency and cryoablation are gaining importance. There is evidence that preserving renal function reduces the risk of death of any cause, cardiovascular events, and hospitalization. Some patients have unfavourable tumor locations or large tumors unsuitable for NSS or ablation which is a clinical problem especially in those with imperative indications to preserve renal function. These patients may benefit from downsizing primary tumors by targeted therapy. This paper provides an overview of the current evidence, safety, controversies, and ongoing trials.

scholarly journals 1637 Ablative Therapies Versus Partial Nephrectomy for Small Renal Masses: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
V W S Chan ◽  
A Abul ◽  
H H L Ng ◽  
F H Osman ◽  
K Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Renal Function ◽  
Propensity Score ◽  
Partial Nephrectomy ◽  
Meta Analysis ◽  
Complication Rates ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Free Survival ◽  
Ablative Therapies

Abstract Introduction The optimal management of small renal masses is unclear. Ablative therapies (AT) have been advocated as a potential alternative due to lower complication rates and non-inferior oncological outcomes. We performed a systematic review to compare AT and partial nephrectomy (PN) in patients with T1aN0M0 renal masses. Method This review is registered on PROSPERO (CRD42020199099). A search was performed on Medline, EMBASE, and Cochrane CENTRAL to identify studies comparing AT and PN. Different modalities and approaches were analysed as subgroups. Outcomes include cancer-specific survival (CSS), overall survival (OS), recurrence-free survival (RFS), metastatic-free survival (MFS), postoperative complications, and change in renal function. Results From 1,351 identified records, 30 studies incorporating 85,837 patients were included for meta-analysis. Patients receiving AT were found to have significantly worse CSS, OS, RFS when compared to patients receiving PN (p < 0.05). Patients undergoing AT have a non-inferior MFS and significantly fewer overall complications (HR: 0.79, 95% CI 0.41-1.51, p = 0.48; RR: 0.71, 95% CI 0.53-0.96, p = 0.03). Patients undergoing AT have a smaller decline in renal function post-operatively (SMD: 0.30, 95% CI 0.11-0.50). When limited to studies with propensity score matching, CSS and RFS are no longer significantly different between the two groups (HR: 1.54, 95% CI 0.67-3.52, p = 0.31, HR: 1.72, 95% CI 0.90-3.28, p = 0.10). Subgroup analyses did not show significant differences between different modalities and approaches of AT in all outcomes. Conclusions AT is potentially non-inferior to PN when managing small renal masses, and more high-quality propensity score-matched studies with long follow-up time are needed to confirm the non-inferiority.

Tumor Anatomy Scoring and Renal Function for Nephron-Sparing Treatment Selection in Patients With Small Renal Masses: A Microsimulation-Based Decision Analysis

2016 ◽  
Vol 207 (2) ◽  
pp. 344-353 ◽  
Author(s):  
Stella K. Kang ◽  
William C. Huang ◽  
Edward Y. Skolnik ◽  
Debra A. Gervais ◽  
R. Scott Braithwaite ◽  
...  
Keyword(s):  
Renal Function ◽  
Decision Analysis ◽  
Treatment Selection ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Nephron Sparing

scholarly journals Radiologic Evaluation of Small Renal Masses (II): Posttreatment Management

2008 ◽  
Vol 2008 ◽  
pp. 1-8 ◽  
Author(s):  
J. Santos ◽  
C. Deltoro ◽  
M. I. Martín ◽  
A. Marhuenda
Keyword(s):  
Renal Function ◽  
Local Recurrence ◽  
Surgical Technique ◽  
Imaging Techniques ◽  
Therapeutic Management ◽  
Imaging Features ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Radiologic Evaluation

The increase in the detection of small renal masses (SRMs) and their best knowledge leads to a change in the therapeutic management of these lesions. The use of a less aggressive surgical technique or even an expectant attitude is the current tendency, in order to preserve as much renal function as possible. Imaging techniques are essential in the followup of these lesions. It allows us to know the postsurgical changes and possible complications due to treatment and the presence of local recurrence and metastases. Furthermore, a close radiological followup of SRM related to ablative treatments is mandatory. The purpose of this article is to reveal the imaging features of complications due to surgical or ablative treatments, local recurrence and metastasis, as well as their followup.

MP54-04 PARTIAL NEPHRECTOMY IS EQUIVALENT TO ACTIVE SURVEILLANCE IN PRESERVING RENAL FUNCTION FOR PATIENTS WITH SMALL RENAL MASSES

2014 ◽  
Vol 191 (4S) ◽  
Author(s):  
Matthew Danzig ◽  
Rashed Ghandour ◽  
Srinath Kotamarti ◽  
Tina Schubert ◽  
Arindam RoyChoudhury ◽  
...  
Keyword(s):  
Renal Function ◽  
Partial Nephrectomy ◽  
Active Surveillance ◽  
Small Renal Masses ◽  
Renal Masses

scholarly journals Split renal function after treatment of small renal masses: comparison between radiofrequency ablation and laparoscopic partial nephrectomy

2020 ◽  
pp. 028418512095628
Author(s):  
Vanessa Acosta Ruiz ◽  
Sarah Båtelsson ◽  
Elina Onkamo ◽  
Lisa Wernroth ◽  
Thomas Nilsson ◽  
...  
Keyword(s):  
Renal Function ◽  
Radiofrequency Ablation ◽  
Partial Nephrectomy ◽  
Ct Images ◽  
Laparoscopic Partial Nephrectomy ◽  
Renal Tumors ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Split Renal Function ◽  
Pre Treatment

Background Radiofrequency ablation (RFA) and laparoscopic partial nephrectomy (LPN) are used to treat small renal masses (SRM; ≤4 cm), although there are conflicting results in the changes in creatinine and estimated glomerular filtration rate (eGFR) after treatment. On contrast-enhanced computed tomography (CE-CT) images, the quantity and quality of renal function can be evaluated by calculating the split renal function (SRF). Purpose To compare renal function after RFA or LPN treatment of SRMs through evaluation of the SRF in the affected kidney. Material and Methods Single T1a renal tumors successfully treated with RFA (n = 60) or LPN (n = 31) were retrospectively compared. The SRF was calculated on pre-treatment CE-CT images and the first follow-up exam after completed treatment. Serum creatinine and eGFR values were collected simultaneously. To compare renal function outcomes, Student’s t-test and multivariable linear regression models (adjusted to RFA/LPN treatment, pre-treatment SRF/eGFR, BMI, age, tumor characteristics, and Charlson Comorbidity Index) were used. Results SRF was reduced in both groups, although reduction was greater in the LPN group (LPN –5.7%) than in the RFA group (RFA –3.5%; P = 0.013). After adjusted analysis, the LPN group still had greater SRF reduction (difference 3.2%, 95% confidence interval 1.3–1.5; P = 0.001). There was no difference between groups in the change of creatinine/eGFR after treatment. Conclusion Both RFA and LPN are nephron-sparing when treating SRMs. However, in this series, reduction of SRF in the affected kidney was smaller after RFA, having a more favorable preservation of renal function than LPN.

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