Mp67-11 Predictive Factors of 60 Days Disease Persistence and 6-12 Months Recurrence After Microwave Ablation Treatment for Small Renal Masses: A Single-Center Institutional Prospective Analysis

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy V (MP67)1 May 2024MP67-11 PREDICTIVE FACTORS OF 60 DAYS DISEASE PERSISTENCE AND 6-12 MONTHS RECURRENCE AFTER MICROWAVE ABLATION TREATMENT FOR SMALL RENAL MASSES: A SINGLE-CENTER INSTITUTIONAL PROSPECTIVE ANALYSIS Filippo Dagnino, Marco Paciotti, Alessandro Uleri, Andrea Piccolini, Pietro Diana, Cesare Saitta, Giuseppe Garofano, Paola Arena, Vittorio Fasulo, Vittorio Pedicini, Alberto Saita, Rodolfo Hurle, Massimo Lazzeri, Giovanni Lughezzani, Paolo Casale, and Nicolò Maria Buffi Filippo DagninoFilippo Dagnino , Marco PaciottiMarco Paciotti , Alessandro UleriAlessandro Uleri , Andrea PiccoliniAndrea Piccolini , Pietro DianaPietro Diana , Cesare SaittaCesare Saitta , Giuseppe GarofanoGiuseppe Garofano , Paola ArenaPaola Arena , Vittorio FasuloVittorio Fasulo , Vittorio PediciniVittorio Pedicini , Alberto SaitaAlberto Saita , Rodolfo HurleRodolfo Hurle , Massimo LazzeriMassimo Lazzeri , Giovanni LughezzaniGiovanni Lughezzani , Paolo CasalePaolo Casale , and Nicolò Maria BuffiNicolò Maria Buffi View All Author Informationhttps://doi.org/10.1097/01.JU.0001009496.54470.10.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Microwave ablation (MWA) is currently considered an alternative to surgery for treating small renal masses (SRM), especially in patients who have previously undergone renal surgery, bear more than one lesion, or have multiple comorbities. However, despite the use of MWA for radical intent, a significant proportion of patients experience disease persistence or recurrence, necessitating subsequent treatment. We aimed to investigate factors associated with disease persistence and recurrence after MWA. METHODS: We analyzed our center prospective data about 159 patients who underwent MWA and after-treatment CT scans at 60 days, 6 months and 12 months from April 2020 to October 2023. Preoperative and postoperative characteristics were reported with median values and corresponding interquartile ranges (IQR). Univariate and multivariate Cox proportional hazards regression (CPHR) models were used to evaluate the impact of lesion size, biopsy histology and PADUA score on disease persistence at 60 days and disease recurrence and 6 and 12 months after MWA. RESULTS: Overall, 107 (67%) patients had no previous renal surgery, while 52 (32.7%) underwent radical partial renal surgery. Median tumor size was 21 (16-30) mm. PADUA risk stratification was low, intermediate, high in 56 (35.2%), 71 (44.6%), 50 (31.4%) of cases. Median preoperative GFR and hemoglobin were 71.3 (53.2-87.6) and 13.9 (12.8-15) and corresponding postoperative values were 65.8 (47.2-86.2) and 13.0 (11.6-14), respectively. Disease persistence rate at 60 days after MWA was 18.2%. In multivariate CPHR model after adjusting for several baseline characteristics, clinical tumor size (HR 1.04, p=0.017, 95% CI 1.006-1.072) and histology (HR 3.42, p=0.017, 95% CI 1.241-9.428) were significantly associated with disease persistence at 60 days after MWA. We determined a 13.2% recurrence rate at 6 months after ablation. In this case univariate CPHR model indicated tumor size (HR 1.03, p=0.04, 95% CI 1.012-1.044), high PADUA score (HR 7.87, p=0.008, 95% CI 1.711-32.187) and histology (HR 1.87, p=0.03, 95% CI 1.022-4.437) as associated with disease recurrence at 6 months. In addition, we reported 12.5% as 12 months after MWA recurrence rate. Univariate CPHR model showed clinical tumor size (HR 1.02, p=0.04, 95% CI 1.012-1.061), high PADUA risk (HR 4.60, p=0.025, 95% CI 1.208-17.526) and biopsy histology (HR 1.20, p=0.04, 95% CI 1.015-3.348) as predictors significantly associated with tumor recurrence at 12 months after MWA. CONCLUSIONS: MWA is a valid treatment option for comorbid patients or subjected to previous kidney surgery. Nevertheless, it comes with a noteworthy risk of disease persistence and recurrence. Our study sheds light on specific factors linked to less favorable oncological outcomes, providing valuable insights for patient counseling and the need for vigilant monitoring. Source of Funding: None © 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 Filippo Dagnino More articles by this author Marco Paciotti More articles by this author Alessandro Uleri More articles by this author Andrea Piccolini More articles by this author Pietro Diana More articles by this author Cesare Saitta More articles by this author Giuseppe Garofano More articles by this author Paola Arena More articles by this author Vittorio Fasulo More articles by this author Vittorio Pedicini More articles by this author Alberto Saita More articles by this author Rodolfo Hurle More articles by this author Massimo Lazzeri More articles by this author Giovanni Lughezzani More articles by this author Paolo Casale More articles by this author Nicolò Maria Buffi More articles by this author Expand All Advertisement PDF downloadLoading ...