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1114 Microwaves induced thermoablation (MWTA) of small solid renal masses: Results of a phase I study
1114 - Microwaves induced thermoablation (MWTA) of small solid renal masses: Results... Page 1 of 2
e1114 Microwaves induced thermoablation (MWTA) of small solid renal masses: Results of a phase I study 1
2
3
4
1
Bartoletti R. , Gontero P. , Simonato A. , Cai T. , Mondaini N. , 1
Meliani E. , Carmignani G. 1
3 2
University of Florence, Dept. of Urology, Florence, Italy, University of
Turin, Dept. of Urology, Turin, Italy, Urology, Genoa, Italy, Trento, Italy
4
3
University of Genoa, Dept. of
Santa Chiara Hospital, Dept. of Urology,
INTRODUCTION & OBJECTIVES: Conservative surgery still represents the gold standard treatment of small solid renal masses although the evidence of patient’s co-morbidities such as cardiovascular and respiratory diseases could represent limiting factors for planning subsequent surgical approaches. MW are a source of energy similar to radio-frequency or cryoablation and could be considered for future clinical percutaneous applications. MWTA consists in a more rapid and homogeneous ablation and a lesser sensitivity to local variation of tissue physical properties when compared to other means of energy delivering. We previously described the “in vivo” effects of MWTA on porcine kidney. Aims of this phase I study were to determine both the tolerability of MWTA used “in vivo” on patients with human renal masses and the effects of heating on ablated tissues. MATERIAL & METHODS: Patients were enrolled in three different urological centres. All patients underwent MWTA of renal masses before clamping renal vascular pedicle immediately prior of the classic open surgery procedure . Pathological samples or tumor tissue were always collected by tru-cut biopsy before MWTA. MWTA induced lesions were determined through a “standard” exposure of 50W for 5 minutes to determine repeteable treatments. Moreover the exposure to MW was extended to healthy renal tissue in all patients candidates to radical nephrectomy to have information on MW energy absorption by either tumor and healthy tissues. The effects of MWTA on patient’s
file://F:\RamShankar\April\04-05-12\Cip\Sour\1114.html
4/7/2012
1114 - Microwaves induced thermoablation (MWTA) of small solid renal masses: Results... Page 2 of 2
e1114a coagulation and tumor/renal vasculature were assessed. Moreover the tumor inner cellular skipping (Triplan Blue) and the diameters obtained from MWTA, were also assessed (S-Index). The number of patients necessary for statistical analysis was 9. RESULTS: Twenty six patients were finally enrolled in this phase I study (14 radical and 12 conservative surgery). The rate of energy absorption was consistently higher for tumor tissue compared to healthy tissue. MW induced lesions size was 44.14 mm (SD±22.59). Mean S Index was 1.08 (SD±0.2). No significant differences between coagulation clinical parameters (D-dimer, INR, APPT) were found. No local bleedings after MWTA treatment have been reported. No residual vital tumor cells inside the MW induced lesions were found. CONCLUSIONS: MWTA demonstrated no local or sistemic toxicity among treated patients. Moreover MWTA seemed able to determine repeteable spheroidal lesions by using a standard of energy (50W) for a pre-determined time of exposure, thus resulting applicable also in patients with clinical relevant co-morbidities and incidentally detected small solid renal masses.
file://F:\RamShankar\April\04-05-12\Cip\Sour\1114.html
4/7/2012
e1114 Microwaves induced thermoablation (MWTA) of small solid renal masses: Results of a phase I study 1
2
3
4
1
Bartoletti R. , Gontero P. , Simonato A. , Cai T. , Mondaini N. , 1
Meliani E. , Carmignani G. 1
3 2
University of Florence, Dept. of Urology, Florence, Italy, University of
Turin, Dept. of Urology, Turin, Italy, Urology, Genoa, Italy, Trento, Italy
4
3
University of Genoa, Dept. of
Santa Chiara Hospital, Dept. of Urology,
INTRODUCTION & OBJECTIVES: Conservative surgery still represents the gold standard treatment of small solid renal masses although the evidence of patient’s co-morbidities such as cardiovascular and respiratory diseases could represent limiting factors for planning subsequent surgical approaches. MW are a source of energy similar to radio-frequency or cryoablation and could be considered for future clinical percutaneous applications. MWTA consists in a more rapid and homogeneous ablation and a lesser sensitivity to local variation of tissue physical properties when compared to other means of energy delivering. We previously described the “in vivo” effects of MWTA on porcine kidney. Aims of this phase I study were to determine both the tolerability of MWTA used “in vivo” on patients with human renal masses and the effects of heating on ablated tissues. MATERIAL & METHODS: Patients were enrolled in three different urological centres. All patients underwent MWTA of renal masses before clamping renal vascular pedicle immediately prior of the classic open surgery procedure . Pathological samples or tumor tissue were always collected by tru-cut biopsy before MWTA. MWTA induced lesions were determined through a “standard” exposure of 50W for 5 minutes to determine repeteable treatments. Moreover the exposure to MW was extended to healthy renal tissue in all patients candidates to radical nephrectomy to have information on MW energy absorption by either tumor and healthy tissues. The effects of MWTA on patient’s
file://F:\RamShankar\April\04-05-12\Cip\Sour\1114.html
4/7/2012
1114 - Microwaves induced thermoablation (MWTA) of small solid renal masses: Results... Page 2 of 2
e1114a coagulation and tumor/renal vasculature were assessed. Moreover the tumor inner cellular skipping (Triplan Blue) and the diameters obtained from MWTA, were also assessed (S-Index). The number of patients necessary for statistical analysis was 9. RESULTS: Twenty six patients were finally enrolled in this phase I study (14 radical and 12 conservative surgery). The rate of energy absorption was consistently higher for tumor tissue compared to healthy tissue. MW induced lesions size was 44.14 mm (SD±22.59). Mean S Index was 1.08 (SD±0.2). No significant differences between coagulation clinical parameters (D-dimer, INR, APPT) were found. No local bleedings after MWTA treatment have been reported. No residual vital tumor cells inside the MW induced lesions were found. CONCLUSIONS: MWTA demonstrated no local or sistemic toxicity among treated patients. Moreover MWTA seemed able to determine repeteable spheroidal lesions by using a standard of energy (50W) for a pre-determined time of exposure, thus resulting applicable also in patients with clinical relevant co-morbidities and incidentally detected small solid renal masses.
file://F:\RamShankar\April\04-05-12\Cip\Sour\1114.html
4/7/2012