[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-433020-105":3,"detail-sidebar-cat-0-en-105":85,"doc-detail-433020-en":135},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":78,"head_meta":80,"extra_data":82,"updated_unix":84},105,"en","the-decline-of-radical-nephrectomy-contemporary-trends-in-the-treatment-of-t1-renal-cell-carcinoma","The decline of radical nephrectomy - Contemporary trends in the treatment of T1 renal cell carcinoma","","Small renal masses are increasingly diagnosed, shifting management away from radical nephrectomy (RN) toward nephron-sparing strategies including partial nephrectomy (PN), thermal ablation (TA), and active surveillance (AS). This retrospective SEER-based study assesses contemporary U.S. trends for cT1 renal cell carcinoma from 2000 to 2021 and evaluates predictors associated with receiving ablative therapies. Results track large-scale adoption patterns and demographic or clinical factors influencing treatment 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Boy","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",12,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69,73],{"name":60,"@type":61,"acceptedAnswer":62},"What treatment trends were observed for clinical stage T1 renal cell carcinoma from 2000 to 2021?","Question",{"text":63,"@type":64},"Partial nephrectomy (PN) increased markedly, thermal ablation also rose, and radical nephrectomy (RN) declined substantially over the study period.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was the study conducted and what data source was used?",{"text":68,"@type":64},"A retrospective cohort study used the National Cancer Institute SEER 22 registries from 2000 to 2021, analyzing adults with unilateral, primary cT1 renal cortical renal cell carcinoma and comparing RN, PN, and ablative therapies.",{"name":70,"@type":61,"acceptedAnswer":71},"Which patient and tumor factors predicted receiving ablation instead of RN?",{"text":72,"@type":64},"Older age, later year of diagnosis, smaller tumors, and higher income were associated with greater likelihood of choosing ablation over RN.",{"name":74,"@type":61,"acceptedAnswer":75},"Why is the use of PN and ablation expected to continue expanding?",{"text":76,"@type":64},"The findings indicate that nephron-sparing approaches increasingly replace RN, and as technology advances, ablation is expected to further broaden, reinforcing the overall shift toward nephron 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trends in the treatment of T1 renal cell carcinoma  \nZorawar Singh 1 | Dylan Brown 1 | Justin James 2 | Atieh D. Ashkezari 1 | Manish A. Vira 1 | Arun Rai 3  \n1Department of Urology, Northwell Health, New Hyde Park, New York, USA  \n2City University of New York School of Medicine, New York, New York, USA 3Department of Urology, James Buchanan Brady Urological Institute at Johns Hopkins Hospital, Baltimore, Maryland, USA  \nCorrespondence  \nZorawar Singh, Northwell Health, Department of Urology, New Hyde Park, NY 11042, USA. Email: [zsingh1@northwell.edu](zsingh1@northwell.edu)  \nAbstract  \nIntroduction: The diagnosis of small renal masses is becoming increasingly common. Management recommendations are shifting from radical nephrectomy (RN) toward nephron-sparing options such as partial nephrectomy (PN), thermal ablation (TA), and active surveillance (AS) . This study aims to present current treatment trends in the USA for treating clinical stage T1 renal cell carcinoma in the largest series to date. Additionally, we sought to identify predictors linked to the receipt of ablative treatments.  \nMethods: We conducted a retrospective cohort study using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) 22 Registries from 2000 to 2021. Adults (≥18 years) with unilateral, primary cT1 renal cortical renal cell carcinoma were included. Treatments analysed were RN, PN, and ablative therapies (radiofrequency, cryoablation, and laser) . Annual trends were assessed, and multinomial logistic regression identified demographic and clinical predictors of treatment selection.  \nResults: A total of 86 642 patients were included. Between 2000 and 2021, PN increased from 16% to 57% and ablation from 1% to 11%, while RN decreased from 84% to 33%( p \u003C 0 .001) . Overall, 6138 ablative treatments were performed, with the majority (n = 5623, 92%) conducted on renal masses \u003C4 cm. The most substantial growth was for tumours \u003C2 cm, with a 17.2% increase in ablation compared to a 3.4% increase for masses >4 cm. Among ablative techniques, cryoablation’s utilization increased most dramatically from 0% to 7% during the study period. Multivariable analysis indicated that predictors for choosing ablation over RN included older age, later year of diagnosis, smaller tumours, and higher income. Conversely, Hispanic ethnicity, marital status, and non-classic RCC subtypes were linked to a higher likelihood of receiving RN versus ablation.  \nConclusion: Over the past two decades, PN and ablation have increasingly replaced RN in the management of cT1 renal masses, particularly for tumours \u003C4 cm. As technology advances, ablation is likely to expand further, reinforcing the shift toward nephron-sparing strategies.  \nThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.  \n© 2026 The Author(s) . BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.  \nBJUI Compass. 2026;7:e70148 .  \n[https://doi.org/10.1002/bco2.70148](https://doi.org/10.1002/bco2.70148)  \n[wileyonlinelibrary.com/journal/bco2](wileyonlinelibrary.com/journal/bco2)  \n1 of 9  \nKEYW OR DS  \nablative therapy, nephron-sparing surgery, partial nephrectomy, renal cell carcinoma, SEER database, treatment trends  \n1 | INTRODUCTION  \nSmall renal masses are diagnosed with increasing frequency.1 Recommended management of these masses has changed over time, with a trend away from radical nephrectomy (RN) toward less invasive approaches including partial nephrectomy (PN), thermal ablation (TA), and active surveillance (AS) .2,3  \nThe shift from RN to PN has been driven by observational4 and experimental5 data showing long-term oncologic equivalence between RN and PN and lower risk of new-onset chronic kidney disease (C","cbCaiumIKyM2Mv5R","https://ap.wps.com/l/cbCaiumIKyM2Mv5R","pdf",401326,"English","# Introduction\n# Methods\n# Results\n# Conclusion","[{\"question\":\"What treatment trends were observed for clinical stage T1 renal cell carcinoma from 2000 to 2021?\",\"answer\":\"Partial nephrectomy (PN) increased markedly, thermal ablation also rose, and radical nephrectomy (RN) declined substantially over the study period.\"},{\"question\":\"How was the study conducted and what data source was used?\",\"answer\":\"A retrospective cohort study used the National Cancer Institute SEER 22 registries from 2000 to 2021, analyzing adults with unilateral, primary cT1 renal cortical renal cell carcinoma and comparing RN, PN, and ablative therapies.\"},{\"question\":\"Which patient and tumor factors predicted receiving ablation instead of RN?\",\"answer\":\"Older age, later year of diagnosis, smaller tumors, and higher income were associated with greater likelihood of choosing ablation over RN.\"},{\"question\":\"Why is the use of PN and ablation expected to continue expanding?\",\"answer\":\"The findings indicate that nephron-sparing approaches increasingly replace RN, and as technology advances, ablation is expected to further broaden, reinforcing the overall shift toward nephron preservation.\"}]","The decline of radical nephrectomy - Contemporary trends in the treatment of T1 renal cell carcinoma | PDF",1790662367,23]