Universität zu Köln

Staehler, Michael ORCID: 0000-0002-4574-6522, Schuler, Tina, Spek, Annabel, Rodler, Severin, Tamalunas, Alexander, Fuerweger, Christoph and Muacevic, Alexander (2022). Propensity Score-Matched Analysis of Single Fraction Robotic Radiosurgery Versus Open Partial Nephrectomy in Renal Cell Carcinoma: Oncological Outcomes. Cureus J Med Sci, 14 (1). PALO ALTO: CUREUS INC. ISSN 2168-8184

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Abstract

Introduction High-dose local stereotactic robotic radiosurgery (RRS) is a non-invasive alternative to surgery in renal masses and selected patients. We have, so far, limited its use to the elderly and patients at high risk from surgery. In this study, we matched patients with renal tumors who were treated with single fraction RRS to patients who underwent open partial nephrectomy (OPN). Methods Between January 2009 and December 2017, we included 571 consecutive patients undergoing OPN and 99 patients who underwent RRS in this retrospective analysis. Patients had to have a follow-up of at least six months and we were able to match 35 with a propensity score. Matching criteria were Eastern Cooperative Oncology Group (ECOG) status, age, clinical tumor, nodes, and metastases (TNM), and tumor diameter. Tumor response, renal function, survival, and adverse events were evaluated every three months until progression or death. Results Median age was 65 years for RRS (range 58-75) and 71 (range 56-76) for OPN (p=0.131). Median diameter of renal tumors was 2.8 cm (range 2.4-3.9) for RRS and 3.5 cm (2.8-4.5) for OPN, p=0.104. Median follow-up was 28.1 months (range 6.0-78.3 months). Local tumor control nine months after RRS and OPN was 98% (95% CI: 89-99%). Renal function remained stable with a median creatinine clearance (Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)) at baseline of 76.8mlmin/1.73m(2) (range 25.3-126.3) and 70.3ml/min/1.73m(2)(range 18.6-127.3) at follow-up (p=0.89). Median overall survival was not reached. No difference in overall survival (OS) was seen in RRS compared to OPN (p=0.459). Conclusions Single fraction RRS is an alternative to OPN in patients unfit for surgery. Oncological and functional results are comparable to those of OPN. Further studies are needed to determine long-term results and limits of RRS in this setting and in younger patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Staehler, Michael UNSPECIFIED orcid.org/0000-0002-4574-6522 UNSPECIFIED Schuler, Tina UNSPECIFIED UNSPECIFIED UNSPECIFIED Spek, Annabel UNSPECIFIED UNSPECIFIED UNSPECIFIED Rodler, Severin UNSPECIFIED UNSPECIFIED UNSPECIFIED Tamalunas, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuerweger, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Muacevic, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-670076
DOI:	10.7759/cureus.21623
Journal or Publication Title:	Cureus J Med Sci
Volume:	14
Number:	1
Date:	2022
Publisher:	CUREUS INC
Place of Publication:	PALO ALTO
ISSN:	2168-8184
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TUMOR SIZE; CRYOABLATION; MASSES; SURVEILLANCE; CONSORTIUM; PREDICT; KIDNEY; GROWTH; RISK Multiple languages Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67007