A comparative analysis of fear of cancer recurrence in patients with small renal masses: Active surveillance versus cryoablation

Acta Oncol. 2024 Jul 22:63:573-579. doi: 10.2340/1651-226X.2024.40418.

Abstract

Background and purpose: The aim of this study was to evaluate and compare the fear of cancer recurrence (FCR) in patients diagnosed with a small renal mass (SRM) and managed with either active surveillance (AS) or minimal invasive renal cryoablation (CA).

Patients/material and methods: A total of 398 patients with SRMs (263 AS and 135 CA patients) were retrospectively identified across three institutions and invited to complete the Fear of Cancer Recurrence-Short Form (FCRI-SF) questionnaire.

Results: No statistically significant differences in FCRI-SF score were observed between the AS (mean = 10.9, standard deviation [SD] = 6.9) and CA (mean = 10.2, SD = 7.2) (p = 0.559) patients, with the mean scores of both groups being below the suggested clinically significant cut-off of 16. A total of 25% of AS and 28% of CA patients reported sub-clinical or clinical levels of FCR (FCRI-SF score > 16). Within the AS group, a weak negative association between FCR severity and age was observed (r = -0.23, p = 0.006), and a statistically significant difference in FCRI-SF score between patients aged more or less than 73 years (p = 0.009).

Interpretation: FCR levels were comparable between AS and CA patients, suggesting that treatment decisions should prioritise clinical factors. Up to 28% of AS and CA patients report clinically significant FCR, highlighting the importance of considering the possibility of FCR, especially in younger patients.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Renal Cell / pathology
  • Carcinoma, Renal Cell / psychology
  • Carcinoma, Renal Cell / surgery
  • Cryosurgery*
  • Fear* / psychology
  • Female
  • Humans
  • Kidney Neoplasms* / pathology
  • Kidney Neoplasms* / psychology
  • Kidney Neoplasms* / surgery
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local* / epidemiology
  • Neoplasm Recurrence, Local* / pathology
  • Neoplasm Recurrence, Local* / psychology
  • Retrospective Studies
  • Surveys and Questionnaires
  • Watchful Waiting* / statistics & numerical data