BACKGROUND Strong evidence comparing effectiveness between nephron-sparing intervention (NSI) and active surveillance (AS) is lacking. Thus, we aim to compare the outcomes of survival, including cancer-specific survival (CSS), overall survival (OS), and cardiovascular-specific survival (CVSS), in patients with renal masses who underwent NSI or AS. METHODS A systematic literature search of PubMed, Web of Science, and EMBASE was performed for citations published prior to September 2018 that described NSI, partial nephrectomy and thermal ablation included, and AS for patients with renal masses and a standard meta-analysis on survival outcomes was then conducted. RESULTS The meta-analysis included seven studies containing 5809 patients. The results comparing NSI with AS were as follows: CSS (hazard ratio (HR) = 0.64, 95% confidence interval (CI): 0.46-0.89, P < 0.001), OS (HR = 0.46, 95%CI: 0.39-0.53, P < 0.001), and CVSS (HR = 0.37, 95%CI: 0.24-0.57, P < 0.001). CONCLUSIONS This systematic review and meta-analysis indicates that NSI is associated with better OS, CSS and CVSS when compared with AS for patients with renal masses. Further better prospective cohort studies are needed to make definitive statements about these different treatment methods.

中文翻译：

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保留肾单位或积极监测对局部肾脏肿块患者的生存获益比较：系统评价和荟萃分析。

背景技术缺乏强有力的证据来比较在保护肾单位的干预措施（NSI）和主动监测（AS）之间的有效性。因此，我们的目的是比较接受NSI或AS治疗的肾脏肿块患者的生存结果，包括癌症特异性生存率（CSS），总体生存率（OS）和心血管特异性生存率（CVSS）。方法对PubMed，Web of Science和EMBASE进行了系统的文献检索，以查找2018年9月之前发表的引文，该引文描述了NSI，包括部分肾切除术和热消融术以及肾肿块患者的AS和对生存结局的标准荟萃分析然后进行。结果荟萃分析包括7项研究，涉及5809例患者。NSI与AS的比较结果如下：CSS（危险比（HR）= 0.64，95％置信区间（CI）：0。46-0.89，P <0.001），OS（HR = 0.46，95％CI：0.39-0.53，P <0.001）和CVSS（HR = 0.37，95％CI：0.24-0.57，P <0.001）。结论这项系统的回顾和荟萃分析表明，对于肾肿块患者，与AS相比，NSI与更好的OS，CSS和CVSS相关。为了对这些不同的治疗方法做出明确的陈述，还需要进行更好的前瞻性队列研究。