SIR Today

“During our clinical rotations, we often met older patients who were hesitant about surgery or had multiple health conditions,” said Arsalan Nadeem, who will present this featured abstract at SIR 2026. “Seeing them navigate these decisions firsthand inspired our team to explore which treatment truly offered the best survival while maintaining safety. Working together on a large dataset allowed us to provide insights into a real-world question faced by IRs and urologists alike.”

Nadeem’s team, which was comprised of graduate doctors and student researchers pursuing IR, reviewed the national Surveillance, Epidemiology, and End Results (SEER) database to compare overall and cancer-specific survival between thermal ablation and partial nephrectomy in adults aged 66 and older.

“The database allowed us to extract survival data for a large cohort, enabling us to match patients in the two treatment arms for characteristics like age, race, ethnicity and gender,” Nadeem said. “By using propensity score matching, we created a balanced, real-world comparison to help guide patient counseling and treatment planning.”

Although 23,511 patients met inclusion criteria, researchers isolated 2,288 patients in each treatment group. Through their review, they found that partial nephrectomy resulted in better overall survival (119 months vs 99 months) as well as cancer-specific survival (202.2 months vs. 188.9). However, age remained a strong predictor of worse outcomes.

Although their findings indicated a higher benefit to partial nephrectomy, Nadeem emphasized that thermal ablation remains an important option for patients who are not eligible for surgery.

“These findings provide real-world evidence to support individualized, patient-centered decision making and highlight the critical role of IRs in multidisciplinary cancer care,” he said.

Nadeem also added that the study did not stratify tumors by stage or size, and most literature on ablation focuses on T1a renal cell carcinoma.

“We plan to build on this work by analyzing outcomes based on tumor stage and lesion size to better define which patient subgroups may achieve comparable benefit from thermal ablation,” he said.

This data, in addition to further studies, will empower physicians to make more targeted clinical decisions, researchers believe.

“This project reflects the passion and collaboration of our trainee team,” Nadeem said. “As aspiring IRs, we are excited to contribute evidence that helps clinicians match the right treatment to the right patient, especially in older and medically complex populations. We hope this work inspires other trainees to explore research in image-guided therapies and multidisciplinary cancer care.”