Systematic review and meta-analysis of ablative therapies for primary localized renal cell carcinoma

Non-invasive and minimally invasive ablative treatment, including sterotactic body radiotherapy, radiofrequency ablation, microwave ablation, and cryoablation have emerged as key treatment options for localized renal cell carcinoma (RCC), especially for patients who are unsuitable for surgery. Systematic review and meta-analysis of 133 studies (January, 2000 to March, 2024; 8910 patients; mean age 67.9 ± 7.3 years; 31.4% female) compared clinical efficacy and safety of these four ablative techniques in patients with localized RCC. All four treatments were effective, with five-year local control rates from 86% to 95%, and were safe, with proportion of patients who reported grade 3 or 4 adverse events 1% to 3%. Risk of bias was moderate in most studies(53%) and no publication bias was observed. The authors conclude that these findings support multidisciplinary discussions of these treatment methods, along with surgery and surveillance, to individualize treatment decisions.