Mp67-17 Perioperative and Long-Term Oncological Outcomes After Local Tumor Ablation for Complex (Padua Score ≥10) Renal Tumors: A Multicenter Analysis

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy V (MP67)1 May 2024MP67-17 PERIOPERATIVE AND LONG-TERM ONCOLOGICAL OUTCOMES AFTER LOCAL TUMOR ABLATION FOR COMPLEX (PADUA SCORE ≥10) RENAL TUMORS: A MULTICENTER ANALYSIS Pietro Piazza, Lorenzo Bianchi, Stefano Luzzago, Marco Bandini, Angelo Mottaran, Sasan Amirhassankhani, Stefano Puliatti, Bernardino De Concilio, Antonio Celia, Carla Serra, Alberta Cappelli, Rita Golfieri, Gennaro Musi, Andrea Gallina, Michele Rizzo, Giovanni Liguori, Carlo Trombetta, Riccardo Schiavina, Ottavio De Cobelli, Francesco Montorsi, and Eugenio Brunocilla Pietro PiazzaPietro Piazza , Lorenzo BianchiLorenzo Bianchi , Stefano LuzzagoStefano Luzzago , Marco BandiniMarco Bandini , Angelo MottaranAngelo Mottaran , Sasan AmirhassankhaniSasan Amirhassankhani , Stefano PuliattiStefano Puliatti , Bernardino De ConcilioBernardino De Concilio , Antonio CeliaAntonio Celia , Carla SerraCarla Serra , Alberta CappelliAlberta Cappelli , Rita GolfieriRita Golfieri , Gennaro MusiGennaro Musi , Andrea GallinaAndrea Gallina , Michele RizzoMichele Rizzo , Giovanni LiguoriGiovanni Liguori , Carlo TrombettaCarlo Trombetta , Riccardo SchiavinaRiccardo Schiavina , Ottavio De CobelliOttavio De Cobelli , Francesco MontorsiFrancesco Montorsi , and Eugenio BrunocillaEugenio Brunocilla View All Author Informationhttps://doi.org/10.1097/01.JU.0001009496.54470.10.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Complex renal masses have a non-negligible risk of perioperative complications due to their inherent anatomical characteristics. Local tumor ablation (LTA) could be an useful tool to approach these tumors in patients unfit for surgery or with hampered renal function. However, oncological and perioperative outcomes of these patients remain undereported. The objective of this study was to report the perioperative and long-term of LTA (including Radiofrequency ablation RFA, Cryoablation Cryo, Microwave ablation MW) for complex masses (PADUA score ≥10). METHODS: We retrospectively evaluated 102 patients treated with LTA for complex (PADUA ≥10) renal tumors at 5 European tertiary centers. Patients were treated with percutaneous RFA, Cryo or MW according to the technique available in each center. Categorical and continuous variables were reported as proportions and median±interquartile ranges (IQR), respectively. Kaplan-Meier estimate was used to investigate 5-years recurrence free survival (RFS). Multivariate Cox's proportional hazard regression was used to identify predictors of local recurrence. Multivariable logistic regression was used to identify predictors of post-operative complications. RESULTS: Overall, 40 (39%), 37 (36%) and 25 (25%) patients underwent RFA, Cryo and MW ablation, respectively. Of those, 55 (54%), 24 (24%), 22 (22%) and 1 (1%) had a PADUA score of 10, 11, 12 and 13, respectively. Median tumor size was 3 (2.2-3.7). At biopsy, 71 (70%), 12 (12%), 3 (3%) and 2 (2%) had clear cell, papillary, chromophobe and mixed renal carcinoma, respectively. In the perioperative period, 26 (25%) patients experienced post-operative complications. During a median follow-up of 60 months (IQR 49-87), 22 (24%) and 9 (12%) patients experienced local and systemic recurrence, respectively, with a 5-years RFS of 57.3%. At multivariable Cox's analysis, papillary histology (HR 0.15, CI 0.01-0.88, p=0.032) was the only independent predictors of RFS. At multivariable logistic regression, the use of RFA (OR 2.56, CI 1.58-8.6, p=0.045) was the only independent predictor of perioperative complications. CONCLUSIONS: LTA is a viable treatment for patients with complex (PADUA ≥10) renal masses, who are considered at higher risk for surgery. However, patients should be accurately counseled due to the higher rates of complication and disease recurrence these patients might experience, when compared with analogues cases treated with nephron sparing surgery. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1105 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Pietro Piazza More articles by this author Lorenzo Bianchi More articles by this author Stefano Luzzago More articles by this author Marco Bandini More articles by this author Angelo Mottaran More articles by this author Sasan Amirhassankhani More articles by this author Stefano Puliatti More articles by this author Bernardino De Concilio More articles by this author Antonio Celia More articles by this author Carla Serra More articles by this author Alberta Cappelli More articles by this author Rita Golfieri More articles by this author Gennaro Musi More articles by this author Andrea Gallina More articles by this author Michele Rizzo More articles by this author Giovanni Liguori More articles by this author Carlo Trombetta More articles by this author Riccardo Schiavina More articles by this author Ottavio De Cobelli More articles by this author Francesco Montorsi More articles by this author Eugenio Brunocilla More articles by this author Expand All Advertisement PDF downloadLoading ...