Computed tomography-guided percutaneous microwave ablation for renal cell carcinoma: evaluating the performance of nephrometry scores.
Carcinoma
Kidney
Microwaves
Renal cell
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
12
11
2022
accepted:
14
05
2023
revised:
22
04
2023
medline:
27
10
2023
pubmed:
15
6
2023
entrez:
15
6
2023
Statut:
ppublish
Résumé
The purpose of the current study is to evaluate the performance of RENAL and mRENAL scores, in the prediction of oncological outcomes in patients treated with microwave ablation (MWA) for (T1) renal cell carcinomas (RCC). Institutional database retrospective research identified 76 patients with a biopsy-proven solitary T1a (84%) or T1b (16%) RCC; all patients underwent CT-guided MWA ablation. Tumor complexity was reviewed by calculating RENAL and mRENAL scores. The majority of the lesions were exophytic (82.9%), with > 7 mm nearness to the collecting system (53.9%), located posteriorly (73.6%), and lower to polar lines (61.8%). Mean RENAL and mRENAL scores were 5.7 (SD = 1.9) and 6.1 (SD = 2.1) respectively. Progression rates were significantly higher with greater tumor size (> 4 cm), with < 4 mm nearness to the collecting system, for tumors crossing a polar line and with the anterior location. None of the above was associated with complications. RENAL and mRENAL scores were significantly higher in patients with incomplete ablation. The ROC analysis showed the significant prognostic ability of both RENAL and mRENAL scores for progression. In both scores, the optimal cut-off point was 6.5. Univariate Cox regression analysis for progression showed a hazard ratio of 7.73 for the RENAL score and 7.48 for the mRENAL score. The results of the present study show that the risk of progression was higher in patients with RENAL and mRENAL score of > 6.5, in T1b tumors, close to the collective system (< 4 mm), crossing polar lines and anterior location. CT-guided percutaneous MWA is a safe and effective technique for the treatment of T1a renal cell carcinomas. Different morphometric parameters of RCC tumors including RENAL and mRENAL score > 6.5, size, proximity to the collecting system, and crossing of polar lines impact the efficacy of MWA and progression survival rates. • The risk of progression is higher in patients with RENAL and mRENAL score > 6.5, in T1b tumors, close to the collective system (< 4 mm), crossing polar lines and anterior location. • The significant prognostic ability of the mRENAL score for progression was higher than the respective of the RENAL score. • Complications were not associated with any of the above factors.
Identifiants
pubmed: 37318604
doi: 10.1007/s00330-023-09774-y
pii: 10.1007/s00330-023-09774-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
7388-7397Informations de copyright
© 2023. The Author(s), under exclusive licence to European Society of Radiology.
Références
Znaor A, Lortet-Tieulent J, Laversanne M, Jemal A, Bray F (2015) International variations and trends in renal cell carcinoma incidence and mortality. Eur Urol 67(3):519–530
pubmed: 25449206
Siegel RL, Miller KD, Jemal A (2018) Cancer statistics, 2018: Cancer Statistics, 2018. CA: Cancer J Clin 68(1):7–30
pubmed: 29313949
Siegel RL, Miller KD, Jemal A (2020) Cancer statistics, 2020. CA: Cancer J Clin 70(1):7–30
pubmed: 31912902
Katsanos K, Mailli L, Krokidis M, McGrath A, Sabharwal T, Adam A (2014) Systematic review and meta-analysis of thermal ablation versus surgical nephrectomy for small renal tumours. Cardiovasc Intervent Radiol 37(2):427–437
pubmed: 24482030
Finelli A, Ismaila N, Russo P (2017) Management of small renal masses: American society of clinical oncology clinical practice guideline summary. J Oncol Pract 13(4):276–278
pubmed: 28118108
Motzer RJ, Jonasch E, Agarwal N et al (2017) Kidney cancer, version 2. NCCN clinical practice guidelines in oncology. J Natl Compr Cancer Netw 15(6):804–834
Campbell S, Uzzo RG, Allaf ME et al (2017) Renal mass and localized renal cancer: AUA guideline. J Urol 198(3):520–529
pubmed: 28479239
Escudier B, Porta C, Schmidinger M et al (2019) Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 30(5):706–720
pubmed: 30788497
Ljungberg B, Albiges L, Abu-Ghanem Y et al (2019) European association of urology guidelines on renal cell carcinoma: the 2019 update. Eur Urol 75(5):799–810
pubmed: 30803729
Krokidis ME, Orsi F, Katsanos K, Helmberger T, Adam A (2017) CIRSE guidelines on percutaneous ablation of small renal cell carcinoma. Cardiovasc Intervent Radiol 40(2):177–191
pubmed: 27987000
Aarts BM, Prevoo W, Meier MA et al (2020) Percutaneous microwave ablation of histologically proven t1 renal cell carcinoma. Cardiovasc Intervent Radiol 43(7):1025–1033
pubmed: 32052093
pmcid: 7300114
Hao G, Hao Y, Cheng Z et al (2018) Local tumor progression after ultrasound-guided percutaneous microwave ablation of stage T1a renal cell carcinoma: Risk factors analysis of 171 tumors. Int J Hyperth 35(1):62–70
Wells SA, Wheeler KM, Mithqal A, Patel MS, Brace CL, Schenkman NS (2016) Percutaneous microwave ablation of T1a and T1b renal cell carcinoma: short-term efficacy and complications with emphasis on tumor complexity and single session treatment. Abdom Radiol (NY) 41:1203–1211
pubmed: 27167230
Gunn A, Rais-Bahrami S, Salei A et al (2019) Percutaneous cryoablation of stage T1b renal cell carcinoma: safety, technical results, and clinical outcomes. J Vasc Interv Radiol 30(3):S41
Efthymiou E, Siatelis A, Liakouras C et al (2021) Computed tomography-guided percutaneous microwave ablation for renal cell carcinoma: Impact of tumor size on the progression survival rates. Diagnostics 11(9):1618
pubmed: 34573960
pmcid: 8472140
Shakeri S, Afshari Mirak S, Mohammadian Bajgiran A et al (2019) The effect of tumor size and location on efficacy and safety of US- and CT- guided percutaneous microwave ablation in renal cell carcinomas. Abdom Radiol (NY) 44(6):2308–2315
pubmed: 30847565
Maciolek KA, Abel EJ, Posielski NM et al (2019) Tumor location does not impact oncologic outcomes for percutaneous microwave ablation of clinical T1a renal cell carcinoma. Eur Radiol 29(11):6319–6329
pubmed: 31016448
Klapperich ME, Abel EJ, Ziemlewicz TJ et al (2017) Effect of tumor complexity and technique on efficacy and complications after percutaneous microwave ablation of stage T1a renal cell carcinoma: a single-center, retrospective study. Radiology 284(1):272–280
pubmed: 28076721
Kutikov A, Uzzo RG (2009) The R. E. N. A. L. Nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol 182(3):844–853
pubmed: 19616235
Gahan JC, Richter MD, Seideman CA et al (2015) The performance of a modified renal nephrometry score in predicting renal mass radiofrequency ablation success. Urology 85(1):125–129
pubmed: 25440815
Schmit GD, Schenck LA, Thompson RH et al (2014) Predicting renal cryoablation complications: new risk score based on tumor size and location and patient history. Radiology 272(3):903–910
pubmed: 24814178
Higgins LJ, Hong K (2015) Renal ablation techniques: state of the art. AJR Am J Roentgenol 205(4):735–741
pubmed: 26204112
Filippiadis D, Mauri G, Marra P, Charalampopoulos G, Gennaro N, De Cobelli F (2019) Percutaneous ablation techniques for renal cell carcinoma: current status and future trends. Int J Hyperth 36(2):21–23
Zhou W, Arellano RS (2018) Thermal ablation of T1c renal cell carcinoma: a comparative assessment of technical performance, procedural outcome, and safety of microwave ablation, radiofrequency ablation, and cryoablation. J Vasc Interv Radiol 29:943–951
pubmed: 29628298
Cornelis FH (2017) The future of percutaneous renal ablation. Diagn Interv Imaging 98:285–286
pubmed: 28363283
Filippiadis DK, Binkert C, Pellerin O, Hoffmann RT, Krajina A, Pereira PL (2017) CIRSE quality assurance document and standards for classification of complications: the CIRSE classification system. Cardiovasc Intervent Radiol 40(8):1141–1146
pubmed: 28584945
Cronan J, Dariushnia S, Bercu Z et al (2019) Systematic review of contemporary evidence for the management of T1 renal cell carcinoma: what IRs need to know for kidney cancer tumor boards. Semin Interv Radiol 36:194–202
Guo J, Arellano RS (2021) Percutaneous microwave ablation of category T1a renal cell carcinoma: intermediate results on safety, technical feasibility, and clinical outcomes of 119 tumors. AJR Am J Roentgenol 216:117–124
pubmed: 32603227
Guo J, Arellano RS (2020) Percutaneous microwave ablation of stage t1b renal cell carcinoma: Short-term assessment of technical feasibility, short-term oncologic outcomes, and safety. J Endourol 34(10):1021–1027
pubmed: 32498630
Simmons MN, Ching CB, Samplaski MK, Park CH, Gill IS (2010) Kidney tumor location measurement using the c index method. J Urol 183(5):1708–1713
pubmed: 20299047
Ficarra V, Novara G, Secco S et al (2009) Preoperative aspects and dimensions used for an anatomical (Padua) classification of renal tumours in patients who are candidates for nephron-sparing surgery. Eur Urol 56(5):786–793
pubmed: 19665284
Aladağ Kurt S, Yücel C, Özhan Oktar S, Erbaş G, Sözen TS, Öner AY (2019) The effectiveness of RENAL nephrometry score in ablated renal tumours via radiofrequency ablation or cryoablation. Turk J Med Sci 49(3):761–768
pubmed: 31062941
pmcid: 7018310
Maxwell AWP, Baird GL, Iannuccilli JD, Mayo-Smith WW, Dupuy DE (2017) Renal cell carcinoma: comparison of renal nephrometry and padua scores with maximum tumor diameter for prediction of local recurrence after thermal ablation. Radiology 283(2):590–597
pubmed: 27875105
Sisul DM, Liss MA, Palazzi KL et al (2013) Renal nephrometry score is associated with complications after renal cryoablation: a multicenter analysis. Urology 81(4):775–780
pubmed: 23434099
Camacho JC, Kokabi N, Xing M et al (2015) RENAL (radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, and location relative to polar lines) nephrometry score predicts early tumor recurrence and complications after percutaneous ablative therapies for renal cell carcinoma: a 5-year experience. J Vasc Interv Radiol 26(5):686–693
pubmed: 25769213
Reyes J, Canter D, Putnam S et al (2013) Thermal ablation of the small renal mass: case selection using the R. E. N. A. L. nephrometry score. Urol Oncol 31(7):1292–1297
pubmed: 22521770
Ierardi AM, Puliti A, Angileri SA et al (2017) Microwave ablation of malignant renal tumours: intermediate-term results and usefulness of RENAL and mRENAL scores for predicting outcomes and complications. Med Oncol 34(5):97
pubmed: 28421553
Seideman CA, Gahan J, Weaver M et al (2013) Renal tumour nephrometry score does not correlate with the risk of radiofrequency ablation complications: nephrometry scoring fails to predict complications of RFA for SRMS. BJU Int 112(8):1121–1124
pubmed: 24053576
Mouli SK, McDevitt JL, Su Y-K et al (2017) Analysis of the RENAL and mRENAL scores and the relative importance of their components in the prediction of complications and local progression after percutaneous renal cryoablation. J Vasc Interv Radiol 28(6):860–867
pubmed: 28291714
Porpiglia F, Volpe A, Billia M, Renard J, Scarpa RM (2008) Assessment of risk factors for complications of laparoscopic partial nephrectomy. Eur Urol 53(3):590–598
pubmed: 17997214
Liu Z-W, Olweny EO, Yin G et al (2013) Prediction of perioperative outcomes following minimally invasive partial nephrectomy: role of the R.E.N.A.L nephrometry score. World J Urol 31(5):1183–1189
pubmed: 22544340
Weizer AZ, Gilbert SM, Roberts WW, Hollenberg BK, Wolf JS Jr (2008) Tailoring technique of laparoscopic partial nephrectomy to tumor characteristics. J Urol 180:1273
pubmed: 18707711
Pantelidou M, Challacombe B, McGrath A et al (2016) Percutaneous radiofrequency ablation versus robotic-assisted partial nephrectomy for the treatment of small renal cell carcinoma. Cardiovasc Intervent Radiol 39(11):1595–1603
pubmed: 27435582
pmcid: 5052326
Iguchi T, Hiraki T, Tomita K et al (2016) Simultaneous biopsy and radiofrequency ablation of T1a renal cell carcinoma. Diagn Interv Imaging 97(11):1159–1164
pubmed: 27256108
Iannuccilli JD, Dupuy DE, Beland MD, Machan JT, Golijanin DJ, Mayo-Smith WW (2015) Effectiveness and safety of computed tomography-guided radiofrequency ablation of renal cancer: a 14-year single institution experience in 203 patients. Eur Radiol 26:1656–1664
pubmed: 26373755
Wah TM, Irving HC, Gregory W, Cartledge J, Joyce AD, Selby PJ (2014) Radiofrequency ablation (RFA) of renal cell carcinoma (RCC): experience in 200 tumours: RFA for RCC. BJU Int 113(3):416–428
pubmed: 24053769
Patel N, King AJ, Breen DJ (2016) Percutaneous image-guided cryoablation of small renal masses. Abdom Radiol (NY) 41(4):754–766
pubmed: 26915090
Georgiades CS, Rodriguez R (2014) Efficacy and safety of percutaneous cryoablation for stage 1a/b renal cell carcinoma: results of a prospective, single-arm, 5-year study. Cardiovasc Intervent Radiol 37(6):1494–1499
pubmed: 24385225
De Cobelli F, Papa M, Panzeri M et al (2020) Percutaneous microwave ablation versus cryoablation in the treatment of t1a renal tumors. Cardiovasc Intervent Radiol 43(1):76–83
pubmed: 31451888