Editing Management of Localized and Locally Advanced Disease (section)

==== Advantages/Disadvantages ====
*'''<span style="color:#ff0000">Advantages (2):</span>'''
*# '''Low morbidity'''
*#* In the Agency for Healthcare Research and Quality (AHRQ) analysis, TA had the most favorable perioperative outcome profile and a similar low risk of harms when compared to other strategies
*# '''Comparable cancer-specific and overall survival outcomes to partial nephrectomy, in select patients'''
* '''<span style="color:#ff0000">Disadvantage</span>'''
*# '''<span style="color:#ff0000">Risk of local recurrence after primary treatment is higher with TA</span>''' (3-10% cryoablation and 5-20% RFA) '''<span style="color:#ff0000">than partial</span>''' (0-3%) '''<span style="color:#ff0000">or radical nephrectomy</span>''' (0%)
*#* '''<span style="color:#ff0000">Local recurrence after TA can be salvaged with repeat TA.</span>'''
*#** '''<span style="color:#ff0000">Patients should be informed of higher risk of requiring secondary procedure</span>''', compared to partial nephrectomy
*#** '''<span style="color:#ff0000">Allowing for second treatment, risk of local recurrence of TA not significantly different than partial nephrectomy.</span>'''
*#* Observational study comparing partial nephrectomy to TA
*#** Design: retrospective cohort study
*#** Population: 1424 cT1a patients managed with partial nephrectomy or TA
*#** Results:
*#*** 26% of RFA and 7% of cryoablation patients did not undergo biopsy
*#*** 3-year local recurrence-free survival rates were 98% for partial nephrectomy, RFA, and cryoablation.
*#** [https://pubmed.ncbi.nlm.nih.gov/25108580/ Thompson, R. Houston, et al. "Comparison of partial nephrectomy and percutaneous ablation for cT1 renal masses." ''European urology'' 67.2 (2015): 252-259.]
*#* Reported rates of local recurrence after TA may represent underestimates because ≈20% of small renal masses are benign rather than RCC, and a pretreatment biopsy has not always been performed.