Repeat partial nephrectomy (PN) for tumors recurring in the ipsilateral kidney is associated with surgical complexity and a higher rate of complications.
To evaluate the local oncologic efficacy of thermal ablation (TA) for renal cell carcinoma (RCC) in the ipsilateral kidney following PN.
We included patients who underwent ablation for renal tumors in the ipsilateral kidney after PN between January 2005 and December 2019. Demographics, tumor size, procedural details, complications, pathology, local oncologic outcomes, and survival outcomes are described.
The procedural, pathologic, and oncologic outcomes are described. Survival rates were estimated using the Kaplan-Meier method.
A total of 66 patients (46 male and 20 female) with a median age of 62 yr (interquartile range [IQR] 52-69) met our inclusion criteria. In these patients, 74 TA procedures were performed for 86 lesions (median tumor size 1.9 cm, IQR 1.6-2.5). Radiofrequency ablation and cryoablation accounted for 60 (81%) and 14 (19%) procedures, respectively. Three patients (3.7%) had Clavien-Dindo grade III complications. Of 65 lesion biopsies, 62 (95.5%) were diagnostic. The most common subtype was clear cell RCC (n = 37). The median imaging follow-up duration was 60 mo (IQR 43-88). Recurrence in the ablation zone occurred for four lesions (4.6%) at a median of 6.9 mo (IQR 6.4-10.7). The rates of overall, recurrence-free, and disease-free survival were 93.1%, 94.4%, and 65.6% at 5 yr, and 71.6%, 94.4%, and 60.1% at 10 yr, respectively. Limitations include the retrospective design and the lack of a control group.
TA is effective for the treatment of RCC in the ipsilateral kidney following PN.
Heat treatment to remove tumor tissue is an effective option for small kidney masses recurring after partial kidney removal for cancer. Long-term follow-up data revealed that this treatment resulted in low recurrence and complication rates.
European urology open science. 2023 Sep 28*** epublish ***
Mohamed E Abdelsalam, Tessa N Hudspeth, Laura Leonards, Samuel B Kusin, Jennifer R Buckley, Roland Bassett, Ahmed Awad, Jose A Karam, Surena F Matin, Thomas Lu, Kamran Ahrar
Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Department of Radiology, Texas Radiology Associates, LLP, Plano, TX, USA., Department of Radiology, North Oaks Medical Center, Hammond, LA, USA., University of Texas Southwestern Medical Center, Dallas, TX, USA., Department of Radiology, University of Missouri, Kansas City, MO, USA., Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.