Purpose

To retrospectively compare long-term oncologic outcomes of percutaneous computed tomography-guided microwave ablation (MWA) and robot-assisted partial nephrectomy (RAPN) for the treatment of stage 1 (T1a and T1b) renal cell carcinoma (RCC) patients.

Materials and Methods

Institutional database research identified all T1 RCC patients who underwent either MWA or RAPN. Models were adjusted with propensity score matching. Kaplan–Meier log-rank test analyses and Cox proportional hazard regression models were used to compare the oncologic outcomes. Patient and tumor characteristics, technical success as well as oncologic outcomes were evaluated and compared between the 2 groups.

Results

After propensity score matching, a total of 71 patients underwent percutaneous MWA (mean age 70 ± 10 years) and 71 underwent RAPN (mean age 60 ± 9 years). At 8-year follow-up, the estimated survival rates for MWA cohort were 98% (95% confidence interval [CI] 95–100%) for overall survival, 97% (95% CI 93–100%) for recurrence-free survival, and 97% (95% CI 93–100%) for metastasis-free survival. The matched cohort that underwent RAPN exhibited survival rates of 100% (95% CI 100–100%) for overall survival, 98% (95% CI 94–100%) for recurrence-free survival, and 98% (95% CI 94–100%) for metastasis-free survival. After performing log-rank testing, these rates were not significantly different (p values of 0.44, 0.67, and 0.67, respectively).

Conclusion

The results of the present study suggest that both MWA and RAPN are equally effective in terms of oncologic outcome for the treatment of T1 RCC.

中文翻译：

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经皮微波消融与机器人辅助部分肾切除术治疗 I 期肾细胞癌：一项侧重于肿瘤结果长期随访的倾向匹配队列研究

目的

回顾性比较经皮计算机断层扫描引导微波消融 (MWA) 和机器人辅助肾部分切除术 (RAPN) 治疗 1 期（T1a 和 T1b）肾细胞癌（RCC）患者的长期肿瘤学结果。

材料和方法

机构数据库研究确定了所有接受 MWA 或 RAPN 的 T1 RCC 患者。通过倾向得分匹配来调整模型。使用 Kaplan-Meier 对数秩检验分析和 Cox 比例风险回归模型来比较肿瘤学结果。对两组患者和肿瘤特征、技术成功以及肿瘤学结果进行了评估和比较。

结果

倾向评分匹配后，共有 71 名患者接受了经皮 MWA（平均年龄 70 ± 10 岁），71 名患者接受了 RAPN（平均年龄 60 ± 9 岁）。 8 年随访时，MWA 队列的总生存率估计为 98%（95% 置信区间 [CI] 95–100%），无复发生存率为 97%（95% CI 93–100%）生存率，无转移生存率 97% (95% CI 93–100%)。接受 RAPN 的匹配队列的总生存率为 100% (95% CI 100–100%)，无复发生存率为 98% (95% CI 94–100%)，无复发生存率为 98% (95% CI 94)。 –100%）无转移生存。执行对数秩检验后，这些比率没有显着差异（p值分别为 0.44、0.67 和 0.67）。

结论

本研究的结果表明，MWA 和 RAPN 在治疗 T1 RCC 的肿瘤学结果方面同样有效。