Top Line: How do outcomes compare for different forms of ablative treatment for localized renal cell carcinoma?
The Study: There are multiple ablative techniques that can be used to treat localized RCC in patients who aren’t surgical candidates. There are also a lot of strong opinions about these techniques with limited data comparing their efficacy. Here’s a systematic review and meta-analysis of studies reporting outcomes for 8910 patients who received primary treatment with SBRT, RFA, microwave ablation, or cryoablation for localized RCC. SBRT performed well when compared to other modalities. The rate of local control at 1, 2, and 5 years was 99%/97%/95% for SBRT, 96%/95%/92% for RFA, 97%/95%/86% for microwave ablation, and 95%/94%/90% for cryoablation. Rates of grade 3-4 were relatively low across the board, but statistically higher after cryoablation than SBRT, microwave ablation, or RFA. Decrease in eGFR was also similar across modalities. Patients treated with SBRT were significantly older than those treated with other modalities (by 5+ years), and they also had significantly larger tumors.
TBL: This meta-analysis shows that SBRT appears to be equally safe and effective in comparison to other forms of ablative treatment for localized RCC. Given its noninvasive nature, SBRT should likely play a larger role in the management of early stage RCC. | Huang, Lancet Oncol 2025
The Study: There are multiple ablative techniques that can be used to treat localized RCC in patients who aren’t surgical candidates. There are also a lot of strong opinions about these techniques with limited data comparing their efficacy. Here’s a systematic review and meta-analysis of studies reporting outcomes for 8910 patients who received primary treatment with SBRT, RFA, microwave ablation, or cryoablation for localized RCC. SBRT performed well when compared to other modalities. The rate of local control at 1, 2, and 5 years was 99%/97%/95% for SBRT, 96%/95%/92% for RFA, 97%/95%/86% for microwave ablation, and 95%/94%/90% for cryoablation. Rates of grade 3-4 were relatively low across the board, but statistically higher after cryoablation than SBRT, microwave ablation, or RFA. Decrease in eGFR was also similar across modalities. Patients treated with SBRT were significantly older than those treated with other modalities (by 5+ years), and they also had significantly larger tumors.
TBL: This meta-analysis shows that SBRT appears to be equally safe and effective in comparison to other forms of ablative treatment for localized RCC. Given its noninvasive nature, SBRT should likely play a larger role in the management of early stage RCC. | Huang, Lancet Oncol 2025