Partial nephrectomy (PN) is the treatment of choice for stage cT1 renal tumors; however, transdermal ablation has recently been used as an option to preserve the renal unit, despite a high recurrence rate. Houston et al. in the Department of Urology at the Mayo Clinic reviewed their experience with partial nephrectomy, percutaneous radiofrequency ablation (RFA), and percutaneous cryoablation for stage cT1 renal tumors and found that recurrence-free survival rates were similar for both PN and ablation, but for stage cT1a patients, metastasis-free survival was higher with partial nephrectomy and cryoablation than with percutaneous radiofrequency ablation. Partial nephrectomy had the best overall survival (possibly due to selection bias). The article was published in a recent issue of European Urology. The study included 1803 patients with cT1N0M0 kidney tumors seen at the Mayo Clinic between 2000 and 2011. Researchers evaluated subjects separately for local recurrence-free, metastasis-free and overall survival. Results showed that of the 1,424 patients with stage cT1a, 1,057 underwent partial nephrectomy, 180 underwent percutaneous radiofrequency ablation, and 187 underwent cryoablation. In this cohort, the 3-year local recurrence-free survival rate was similar for patients who underwent the three different treatment modalities, all at 98%. The 3-year metastasis-free survival rates were 99%, 93%, and 100% for patients undergoing partial nephrectomy, percutaneous radiofrequency ablation, and cryoablation, respectively, and were higher for patients after partial nephrectomy and cryoablation compared with percutaneous radiofrequency ablation. Of the 379 cT1b patients, 326 and 53 underwent partial nephrectomy and cryoablation, respectively (8 patients with percutaneous radiofrequency ablation were excluded). These patient assessments showed similar local recurrence-free and metastasis-free survival rates for both partial nephrectomy and cryoablation. Among all cT1a and cT1b patients, those who underwent partial nephrectomy were relatively younger, had lower Charlson scores, and had the highest overall survival rates. These results suggest that the local recurrence-free survival rates for patients with stage cT1a after partial nephrectomy, percutaneous radiofrequency ablation, and cryoablation are similar, which is less consistent with the AUA guidelines, which state that recurrence-free survival rates are on average 8 to 10% lower for patients after percutaneous radiofrequency ablation and cryoablation than for patients after partial nephrectomy. The higher recurrence-free survival rate in this trial may be due to the judicious selection of the population undergoing percutaneous radiofrequency ablation and cryoablation. Percutaneous radiofrequency ablation is more effective for small peripheral renal cancers, whereas cryoablation is more appropriate for patients with tumors larger than 3 cm or concentrated in the interior of the kidney. Metastasis-free survival was similar for both cT1a and cT1b stage patients after partial nephrectomy and cryoablation, but metastasis-free survival was lower for cT1a stage patients who underwent RFA. Nevertheless, the metastasis-free survival rates were higher for all three. In addition, overall survival was higher in patients after partial nephrectomy, which may be related to the fact that these patients were younger and had lower Charlson scores. Although this study has many limitations, it provides a richer picture of the treatment options for stage cT1 renal tumors. If the findings in this article are further confirmed by in-depth studies, relevant clinical guidelines will be rewritten. We look forward to conducting more relevant studies.