Mp56-08 Treatment After Renal Mass Thermal Ablation Treatment Failure

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV (MP56)1 May 2024MP56-08 TREATMENT AFTER RENAL MASS THERMAL ABLATION TREATMENT FAILURE Matthew Larson, Nicholas Choi, Jeffrey Holzbeierlein, and David Duchene Matthew LarsonMatthew Larson , Nicholas ChoiNicholas Choi , Jeffrey HolzbeierleinJeffrey Holzbeierlein , and David DucheneDavid Duchene View All Author Informationhttps://doi.org/10.1097/01.JU.0001008940.44711.d4.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Thermal ablation is a guideline recommended option for treatment of renal masses <3 cm in size. Recurrence rate after thermal ablation varies in the literature from 3-15%. Very little is known about the nature of these recurrences or how they are typically managed. We examine the recurrence patterns and subsequent treatment outcomes of of recurrent enhancing masses after thermal ablation at our institution. METHODS: We performed a retrospective review of patients undergoing thermal ablation at our institution between 2012-2021. Inclusion criteria included age >18, no evidence of advanced disease at time of ablation, and evidence contrast enhancement at the site of the ablation during follow-up. Patients were excluded if they had not completed cross-sectional contrast imaging at least one year following treatment. We then performed descriptive analysis of these recurrences and their clinical management. RESULTS: We identified 53 patients who experienced treatment failure after renal mass thermal ablation. Mean tumor size was 2.7 cm (SD 1.1 cm) and median RENAL nephrometry score was 7.5 amongst these patients. The median time to detection of persistent disease was 7 months. Subsequent treatments included repeat ablation n=32, multiple repeat ablations n=14, nephrectomy n=3, and surveillance n=3. Among patient with recurrences, 12/52 (23%) experienced tumor growth >4 mm per year over their treatment course, 5/52 (9.6%) patients experienced T-stage progression, and 4/52 (7.7%) patient experienced metastasis. CONCLUSIONS: Treatment of enhancing renal lesions following thermal mass ablation can take form of repeat ablation or surgery. In our case series, a relatively high number of patients required more than one subsequent ablation. Among patients who had failed the first treatment, there was a relatively high proportion of patients experiencing adverse events such as rapid tumor growth, progression, or even metastasis suggesting a possible more aggressive/resistant biology of these tumors. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e928 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Matthew Larson More articles by this author Nicholas Choi More articles by this author Jeffrey Holzbeierlein More articles by this author David Duchene More articles by this author Expand All Advertisement PDF downloadLoading ...