(HealthDay News) — Cryoablation is more effective than heat-based thermal ablation for patients with T1a renal cell carcinoma who have larger tumors, according to a study published in The Journal of Urology.

The study showed that, for patients with tumors measuring 3.1-4 cm, cancer-specific mortality was 2-fold higher with heat-based thermal ablation than with cryoablation. However, cancer-specific mortality was similar with both treatments for patients with tumors measuring 3 cm or smaller.

Researchers compared cancer-specific mortality in patients with clinical T1a stage renal cell carcinoma treated with cryoablation or heat-based thermal ablation.

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Among patients with tumors measuring 3.1-4 cm, the researchers matched 757 cryoablations and 388 heat-based thermal ablations via propensity score matching. Among patients with tumors measuring 3 cm or smaller, the researchers matched 2217 cryoablations and 1114 heat-based thermal ablations.

For patients with tumors measuring 3.1-4 cm, heat-based thermal ablation was associated with increased cancer-specific mortality compared with cryoablation (hazard ratio, 2.02; 95% CI, 1.29-3.17; P <.001).

For patients with tumors of 3 cm or smaller, there was no significant difference in cancer-specific mortality with the 2 treatments (hazard ratio, 1.13; 95% CI, 0.80-1.58; P =.5).

“Our findings corroborated that, in cT1a patients with tumor size 3.1-4 cm, cancer-specific mortality is two-fold higher after heat-based thermal ablation vs cryoablation,” the researchers wrote. “Conversely, in patients with tumor size ≤3 cm either ablation technique is equally valid. These findings should be considered at clinical decision making and informed consent.”

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