(HealthDay News) — For patients with early-stage renal cell carcinoma, heat-based thermal ablation is associated with increased cancer-specific mortality with tumor size 3.1 to 4 cm, while cancer-specific mortality is similar for heat-based thermal ablation and cryoablation with tumor size ≤3 cm, according to a study published online Nov. 28 in The Journal of Urology.
Gabriele Sorce, M.D., from IRCCS San Raffaele Scientific Institute in Milan, Italy, and colleagues compared cancer-specific mortality among patients with clinical T1a stage renal cell carcinoma treated with cryoablation or heat-based thermal ablation. Data were included for 1,080 and 388 patients with tumor size 3.1 to 4 cm; after up to 2:1 propensity score matching, 757 cryoablations and 388 heat-based thermal ablations were included. In addition, 3,354 and 1,114 patients with tumor size ≤3 cm treated with cryoablation and heat-based thermal ablation, respectively, were included; after up to 2:1 propensity score matching, 2,217 and 1,114, respectively, were included.
The researchers found that heat-based thermal ablation was associated with increased cancer-specific mortality compared with cryoablation, after propensity score matching and in multivariable competing risks regression models for patients with tumor size 3.1 to 4 cm (hazard ratio, 2.02; 95 percent confidence interval, 1.29 to 3.17; P < 0.001). Among patients with tumor size ≤3 cm, heat-based thermal ablation was not associated with increased cancer-specific mortality compared with cryoablation (hazard ratio, 1.13; 95 percent confidence interval, 0.80 to 1.58; P = 0.5).
“We believe our findings have important implications for clinical decision-making and informed consent for patients with these small, potentially curable kidney cancers,” Sorce said in a statement.