Intermediate Outcomes and Predictors of Efficacy in the Radiofrequency Ablation of 100 Pathologically Proven Renal Cell Carcinomas |
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| Institution: | 1. Department of Radiology, David Geffen School of Medicine at the University of California, Los Angeles, 757 Westwood Plaza, Suite 2125, Los Angeles, CA 90095;2. Department of Biostatistics, David Geffen School of Medicine at the University of California, Los Angeles, 757 Westwood Plaza, Suite 2125, Los Angeles, CA 90095;3. Department of Urology, David Geffen School of Medicine at the University of California, Los Angeles, 757 Westwood Plaza, Suite 2125, Los Angeles, CA 90095;1. Department of Radiology, Henan Cancer Hospital, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China;2. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea;3. Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea;1. University of Texas MD Anderson Cancer Center, Houston, Texas;2. Rhode Island Hospital, Providence, Rhode Island;3. Albert Einstein College of Medicine, Bronx, New York, Society of Nuclear Medicine and Molecular Imaging;4. Emory University Hospital, Atlanta, Georgia;5. University of Washington, Seattle, Washington, American Urological Association;6. Scottsdale Medical Imaging, Scottsdale, Arizona;7. University of Utah, Salt Lake City, Utah;8. The University of Chicago Medical Center, Chicago, Illinois;9. Brigham and Women’s Hospital, Boston, Massachusetts;10. Northwestern University, Chicago, Illinois;11. Duke University Medical Center, Durham, North Carolina, American Urological Association;12. Cleveland Clinic, Cleveland, Ohio;13. University of California Los Angeles Medical Center, Los Angeles, California;14. George Washington University Hospital, Washington, District of Columbia;15. University of California San Francisco School of Medicine, San Francisco, California;p. Oakland University William Beaumont School of Medicine, Troy, Michigan;q. University of Alabama at Birmingham, Birmingham, Alabama;1. University of Utah, Salt Lake City, Utah;2. Cleveland Clinic, Cleveland, Ohio;3. Northwestern University, Chicago, Illinois;4. Rhode Island Hospital, Providence, Rhode Island;5. Intermountain Urological Institute, Murray, Utah;6. Albert Einstein College of Medicine, Bronx, New York;7. Emory University Hospital, Atlanta, Georgia;8. University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania;9. Scottsdale Medical Imaging, Scottsdale, Arizona;10. Duke University Medical Center, Durham, North Carolina;11. Universty of California Los Angeles Medical Center, Los Angeles, California;12. Brigham & Women’s Hospital, Boston, Massachusetts;13. University of Texas MD Anderson Cancer Center, Houston, Texas;14. Oakland University William Beaumont School of Medicine, Troy, Michigan |
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| Abstract: | PurposeTo determine oncologic outcomes and predictors of primary efficacy, including RENAL nephrometry scores (radius, exophytic/endophytic properties, nearness of tumor to collecting system or sinus, anterior/posterior, location relative to polar lines), after percutaneous radiofrequency (RF) ablation of proven renal cell carcinoma (RCC).Materials and MethodsPatients who underwent percutaneous computed tomography– and ultrasound-guided RF ablation for histologically proven RCC from 2004 to 2011 were evaluated. Clinical data, pathologic findings, technical details, and outcomes were reviewed. Univariate and multivariate logistic regression analysis was performed to determine predictors of primary technique effectiveness and complications. Local tumor progression–free, metastasis-free, and overall survival were calculated. One hundred RCC lesions underwent 115 RF ablation sessions in 84 patients. Median follow-up was 24 months (mean, 27 mo; range, 1–106 mo).ResultsEfficacy of RF ablation was defined per International Working Group of Image-Guided Tumor Ablation criteria. Total, primary, and secondary technique effectiveness rates were 95% (95 of 100), 86% (86 of 100), and 9% (nine of 100), respectively. Primary efficacy was associated with size (P < .001), proximity to collecting system (P = .001), RENAL nephrometry score (P < .001), and number of ablation zones (P < .001). Complications occurred in 13% of patients, without procedure-related deaths. The median 2.1-year local progression–free, metastasis-free, disease-specific, and overall survival rates were 86%, 98.7%, 100%, and 97.6%, respectively.ConclusionsPercutaneous image-guided RF ablation for RCC provides excellent intermediate oncologic control. Location, size, proximity to the collecting system, low RENAL nephrometry score, and number of ablation zones predict primary efficacy. |
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| Keywords: | IWG-IGT"} {"#name":"keyword" "$":{"id":"key0010"} "$$":[{"#name":"text" "_":"International Working Group of Image-Guided Tumor Ablation RENAL"} {"#name":"keyword" "$":{"id":"key0020"} "$$":[{"#name":"text" "_":"Radius Exophytic/Endophytic properties Nearness of tumor to collecting system or sinus Anterior/posterior Location relative to polar lines RCC"} {"#name":"keyword" "$":{"id":"key0030"} "$$":[{"#name":"text" "_":"renal cell carcinoma RF"} {"#name":"keyword" "$":{"id":"key0040"} "$$":[{"#name":"text" "_":"radiofrequency |
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