Mp67-10 15-Year Follow-Up of Oncologic and Renal Function Outcomes: Radiofrequency Ablation of Renal Tumors 3-7 Cm Using Fiberoptic, Non-Conducting Temperature Monitoring

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy V (MP67)1 May 2024MP67-10 15-YEAR FOLLOW-UP OF ONCOLOGIC AND RENAL FUNCTION OUTCOMES: RADIOFREQUENCY ABLATION OF RENAL TUMORS 3-7 CM USING FIBEROPTIC, NON-CONDUCTING TEMPERATURE MONITORING Robert I. Carey, Genesis G. Dolgetta, Tonya S. King, Benjamin J. Behers, Spencer Kortum, Pedro Briceno, and Karim Ghazli Robert I. CareyRobert I. Carey , Genesis G. DolgettaGenesis G. Dolgetta , Tonya S. KingTonya S. King , Benjamin J. BehersBenjamin J. Behers , Spencer KortumSpencer Kortum , Pedro BricenoPedro Briceno , and Karim GhazliKarim Ghazli View All Author Informationhttps://doi.org/10.1097/01.JU.0001009496.54470.10.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In this study we describe the 15-year follow up of oncologic and renal function outcomes for a cohort of patients who underwent laparoscopic radiofrequency ablation (LRFA) of solid-enhancing renal masses (SERMs) with real time temperature monitoring of the ablation zone with non-conducting fiberoptic thermistors. METHODS: LRFA was performed with a Covidien Cooltip probe system using multiple probes and multi-pass technique. Direct real-time, fiberoptic temperature monitoring was performed for each case with temperature goals of greater than 60 degrees C achieved at the deep and peripheral margins. RESULTS: Mean tumor size 3.5 cm, median tumor volume 17.2 cm3, and mean RENAL nephrometry score 6.8. Mean GFR was 60.2 pre-surgery, 55.7 at 3 months, and 51.0 at 3 years. Thirty-one patients were female (41.3%), laterality was left 39 (52.0%) and right 36 (48.0%). Pathology showed renal cell carcinoma 70.3% and oncocytoma/AML 29.7%. Three patients required partial nephrectomy for locally recurrent renal cell carcinoma (RCC), while four patients required radical nephrectomy. Only one local recurrence developed metastasis. Overall, there were four instances of metastasis after LRFA leading to disease-specific mortality (DSM) and two without DSM.The 15-year overall survival rate was 0.53, while disease-specific survival (DSS) was 0.94. The risk of overall mortality was 0.26 times lower for ASA 2 vs. 3/4 (p=0.001), 2.1 times greater for every 1 unit increase in log transformed tumor volume (p=0.011) 0.64 times lower for every 20-unit increase (1 SD) in calculated pre GFR (p=0.015), with adjustment for nephrometry score. Nephrometry score was the most significant predictor of salvage therapy (OR 4.0 for every 1-unit increase, p=0.001), and metastasis (OR 2.4 for every 1-unit increase, p=0.009). CONCLUSIONS: This study documents the natural history of LRFA patients with 3-7 cm SERMs followed for 14 years. Although LRFA is feasible with overall excellent preservation of kidney function and 94% DSS, preservation of renal function and RFS decline inversely with tumor size and RENAL nephrometry score. Local tumor bed recurrence, metastasis, and DSM occur over long term follow up with these large tumors despite the independent temperature monitoring. Long term follow-up identified four deaths from metastatic RCC, one of which had pre-existing metastasis but two of which were in T1a patients. Source of Funding: The Burzik Foundation © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1101 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Robert I. Carey More articles by this author Genesis G. Dolgetta More articles by this author Tonya S. King More articles by this author Benjamin J. Behers More articles by this author Spencer Kortum More articles by this author Pedro Briceno More articles by this author Karim Ghazli More articles by this author Expand All Advertisement PDF downloadLoading ...