Partial nephrectomy versus radiofrequency ablation in patients with cT1a renal cell carcinoma: A surveillance, epidemiology, end results (SEER) analysis

Radiofrequency ablation (RFA) has been proposed for T1a renal cell carcinoma (RCC). The present study compared partial nephrectomy (PN) with RFA for T1a RCC stratified by tumor sizes. We selected patients with RCC and underwent PN or RFA through the surveillance, epidemiology, end results (SEER) database. The Kaplan-Meier method and Cox proportional hazards regression model were conducted. Inverse probability of treatment weights was conducted for sensitivity analysis. We enrolled 15,692 patients in the unmatched cohort, 15,392 (98.1%) underwent PN, and 300 (1.9%) underwent RFA. For tumor ≦ 2 cm, PN was equal to RFA in terms of overall survival (OS) (P > .05) and cancer-specific survival (CSS) (P > .05). For tumor size 2 to 3 cm, PN is likely to have a better OS (P < .05)and comparable CSS (P > .05). For > 3 cm tumor, PN might be associated with higher OS (P < .05) and CSS (P < .05) compared with RFA. In conclusion, PN had a similar OS and CSS compared with RFA in tumor size ≦ 2 cm, RFA could be offered for elderly or patients with comorbidity. For > 2 cm tumors, RFA is not recommended. However, further randomized controlled trials are further required to validate our results.