Pd23-10 Adrenal Metastasis Ablation in Oligometastatic Renal Cell Carcinoma

You have accessJournal of UrologyAdrenal (PD23)1 May 2024PD23-10 ADRENAL METASTASIS ABLATION IN OLIGOMETASTATIC RENAL CELL CARCINOMA Kamil Malshy, Anna Ochsner, Borivoj Golijanin, Sari Khaleel, Bryan Jay, Emily Barry, Scott Collins, Aaron Maxwell, Anthony Mega, and Dragan Golijanin Kamil MalshyKamil Malshy , Anna OchsnerAnna Ochsner , Borivoj GolijaninBorivoj Golijanin , Sari KhaleelSari Khaleel , Bryan JayBryan Jay , Emily BarryEmily Barry , Scott CollinsScott Collins , Aaron MaxwellAaron Maxwell , Anthony MegaAnthony Mega , and Dragan GolijaninDragan Golijanin View All Author Informationhttps://doi.org/10.1097/01.JU.0001008664.51020.58.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Adrenal metastasectomy appears to improve survival rates in patients with oligometastatic renal cell carcinoma (OMRCC). In this study we reviewed our experience with percutaneous ablation of OMRCC adrenal lesions. METHODS: The records of OMRCC patients with adrenal lesions ablation (ALA) from January 2006 to July 2023 were retrospectively reviewed. 1-5 metastatic lesions were considered OMRCC. Patients were assessed for disease progression, local recurrence, and complications. Data analysis was performed using R 4.3 (R Core Team, 2023). RESULTS: 9 males and 1 female, with a median age of 65 (Interquartile Range (IQR) 60-73), had 15 percutaneous ALA for OMRCC. 5 had single ablation, 2 bilateral ablations, and 3 needed repeat ablations. Median lesion size was 27mm (IQR 22-30). Microwave and radiofrequency ALA was performed on 12 and 3 cases, respectively. All patients had previous nephrectomy, including 4 ipsilateral adrenalectomies. Prior to ALA, 3 patients received systemic treatment. The average time to metastasis was 3.3 years (IQR 0.3-3.92). There were on average 1.6 (IQR 1-2) metastatic sites. Prior to ALA no endocrine abnormalities were documented. In all ALA cases, the intent was to cure; 2/10 of the cases had localized pain concurrently. International Metastatic RCC Database Consortium classified 10 patients as intermediate risk and 5 as good risk for each procedure. Safety hydro dissection was used in 9/15 cases. 1 patient was admitted to the intensive care unit after experiencing an adrenergic crisis and discharged after 7 days. 1 patient was readmitted to the ER due to pain at the ALA site. 3/10 patients had same adrenal disease recurrence, all 3 had re-ALA after a median time of 7 months (min, max 3.9,11.2). 6/10 patients received systemic therapy over an average of 10 (±11.2) cycles including 3 patients who underwent treatment before ALA. Over a median follow-up time of 39.2 (31.2-60.6) months, 3/10 had disease progression and eventually died from the disease. 2 patients died from other causes. As a result, OMRCC treated with ALA had a 3-year cancer-specific survival rate of 70%. Figure 1 illustrates the disease course of each patient. CONCLUSIONS: ALA for OMRCC is a relatively safe procedure with good local control rates. Adapting these treatment methods to the right patient is still a work in progress in the era of immunotherapy treatments. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e528 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Kamil Malshy More articles by this author Anna Ochsner More articles by this author Borivoj Golijanin More articles by this author Sari Khaleel More articles by this author Bryan Jay More articles by this author Emily Barry More articles by this author Scott Collins More articles by this author Aaron Maxwell More articles by this author Anthony Mega More articles by this author Dragan Golijanin More articles by this author Expand All Advertisement PDF downloadLoading ...