Comparison among cryoablation, radiofrequency ablation, and partial nephrectomy for renal cell carcinomas sized smaller than 2 cm or sized 2-4 cm: A population-based study

This study aimed to compare radiofrequency ablation (RFA), cryoablation (CRA), and partial nephrectomy (PN) for renal cell carcinoma (RCC) sized ≤2 cm or 2 to 4 cm.The Surveillance, Epidemiology, and End Results (SEER) database was used to identify 17,234 patients diagnosed with T1aN0M0 RCC from 2004 to 2015. Overall survival (OS) and cancer-specific survival (CSS) were compared among patients who were treated using PN, CRA, or RFA. The Cox proportional hazards model was used to determine prognostic factors for survival.In patients with RCCs sized 2 to 4 cm, better OS and CSS were observed with PN than with CRA or RFA. On multivariable analysis, compared to PN, CRA and RFA were independently associated with poor OS and CSS in patients with RCCs sized 2 to 4 cm. In patients with RCCs sized ≤2 cm, better OS was observed with PN than with CRA or RFA; however, CSS was similar. On multivariable analysis, compared to PN, RFA was independently associated with poor OS in patients with RCCs sized ≤2 cm.CRA or RFA should not be recommended for patients with RCCs sized 2 to 4 cm; PN is an effective treatment modality in these patients. For patients with RCCs sized ≤2 cm, CRA can be an equally effective alternative to PN.