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Predictors of renal function following percutaneous renal cryoablation
JVIR
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Scientific Session
Sunday
other non-renal primary cancer: a tertiary cancer center experience M. Abdelsalam1, S. Sabir1, S. Kusin1, S. Matin1, C. Wood1, J. Karam1, K. Ahrar1; 1The University of Texas MD Anderson Cancer Cancer, Houston, TX
3:27 PM
Abstract No. 84
Predictors of renal function following percutaneous renal cryoablation D. Daye1, H. Vadvala1, V. Furtado1, R. Arellano1, A. Thabet1, P. Mueller1, R. Uppot1; 1Massachusetts General Hospital, Boston, MA Purpose: We aim to assess the factors associated with renal function preservation or decline in patients who underwent percutaneous renal cryoablation. Materials: In this IRB-approved HIPAA-compliant study, we performed a retrospective review of 39 percutaneous cryoablation procedures on renal tumors performed between April 2009 and August 2015 at our academic tertiary medical center. The following data were collected: patient
S39
demographics, BMI, prior medical history, prior surgical history, and characteristics of ablated lesion including lesion location and size. GFR was used as a surrogate marker of renal function and was collected at ablation, 1 month following ablation and 6 months following ablation. Linear regression was performed to assess for independent predictors of renal function at each time point following cryoablation. GFR was used as the outcome variable. The Wald test was used to assess for significant independent contribution of the assessed variables. Results: Of the 39 patients identified, 76% were male; 24% were female. The average patient age was 70.3 ⫾ 1.86 years. 13% of patients had prior radical nephrectomy; 23% of patients had prior partial nephrectomy. Of the lesions treated, 60% were in the right kidney and the average lesions size was 2.9 ⫾ 0.23 cm. The mean GFR at 1 month following ablation was 50.9 ⫾ 3.9 ml/min and 49.5 ⫾ 4 ml/min at 6 months following ablation. Linear regression with GFR as the outcome variable revealed that female sex (p ¼ 0.005), lack of history of radical nephrectomy (p ¼ 0.020) and smaller ablated lesion size (p ¼ 0.004) are independently significantly associated with higher GFR at 1 month post-cryoablation. Similarly, female sex (p ¼ 0.036) and smaller ablated lesion size (p ¼ 0.004) are associated with higher GFR at 6 months following renal cryoablation. Conclusions: Female sex and smaller ablated lesion size are independently associated with better renal function at 1 and 6 months following cryoablation. Lack of history of radical nephrectomy is associated with better GFR at 1 month following ablation. Review of these factors may improve pre-procedure patient counseling and personalize management decisions in patients undergoing renal cryoablation.
3:36 PM
Abstract No. 85
Analysis of the RENAL and mRENAL scores in the prediction of complications and local progression after percutaneous renal cryoablation J. McDevitt1, S. Mouli1, Y. Su1, A. Ragin1, Y. Gao1, A. Nemcek1, R. Lewandowski1, R. Salem1, K. Sato1; 1 Northwestern University Feinberg School of Medicine, Chicago, IL Purpose: Due to the uncertainty on the utility of the RENAL nephrometry score to predict complications and recurrence after percutaneous cryoablation, a modified RENAL (mRENAL) score has been proposed for radiofrequency ablation. Our purpose is to determine if the mRENAL score has any utility in predicting complications and recurrence after percutaneous cryoablation. Materials: We retrospectively reviewed primary masses treated with CT-guided percutaneous renal cryoablation between June 2007 and May 2016. The RENAL and mRENAL scores were used to stratify masses into low, medium, and high complexity tertiles. Complications were characterized by SIR criteria. Multivariate Logistic regression and Kaplan-Meier analysis were used to evaluate predictors of complications and local progression, respectively. Results: There were 95 renal cryoablation procedures on 86 patients. 89 of the ablations had at least one follow-up imaging
SUNDAY: Scientific Sessions
Purpose: To evaluate survival rates of Image-guided thermal ablation (TA) of pathologically proven T1a Renal cell carcinoma (RCC) in patients non-renal primaries. Materials: We reviewed patients with T1a RCC (o 4 cm) between 2005 and 2014 who underwent TA. We excluded patients with syndromes, and those with prior history of or bilateral RCC. We recorded: Demographics, any prior or current Cancer history, primary tumor histology and its status (remission or under therapy), local/systemic recurrence, survival/death and cause of death. Three groups were created based on primary status; patients with (A) RCC only, (B) other non-renal primary malignancy under treatment or (C) other non-renal primary malignancy in remission. Overall survival (OS) and disease free survival (DFS) were estimated using the Kaplan-Meier productlimit estimator and we conducted a log-rank test to compare the 3 groups. We also estimated the cumulative incidence of recurrence (CIR) by primary status using the methods of Gooley et al. Results: One hundred and ten TA for 109 lesions were performed in 109 patients (66 male and 43 females, average age 64 years). Groups (A), (B) and (C) were 46, 18 and 45 patients respectively. For groups (B) and (C), 56 patients had only 1 other primary cancer than RCC e.g. Hematological malignancies, colorectal, breast. Five and 3 patients had 2 and 3 other primary cancers, respectively. Post procedural recurrence developed in 3 patients (4%). None of the patient developed metastasis or died from RCC. The median OS and DFS were 8.39 and 6.57 years respectively with no statistical difference between 3 groups. One-, 3-, and 5-yr CIR for the whole population were 0.03 (95% CI: 0.01–0.07), 0.05 (95% CI: 0.02–0.10), 0.06 (95% CI: 0.03–0.13) respectively. Primary malignancies status was not significantly associated with increased risk of recurrence or disease. Conclusions: Image-guided TA is an effective treatment for T1a RCC in the setting of other non-renal malignancies. In our study, Primary malignancies status (in Remission or under therapy) did not have discernible impact on the thermal ablation effectiveness, OS, DFS or CIR.
’
’
Scientific Session
Sunday
other non-renal primary cancer: a tertiary cancer center experience M. Abdelsalam1, S. Sabir1, S. Kusin1, S. Matin1, C. Wood1, J. Karam1, K. Ahrar1; 1The University of Texas MD Anderson Cancer Cancer, Houston, TX
3:27 PM
Abstract No. 84
Predictors of renal function following percutaneous renal cryoablation D. Daye1, H. Vadvala1, V. Furtado1, R. Arellano1, A. Thabet1, P. Mueller1, R. Uppot1; 1Massachusetts General Hospital, Boston, MA Purpose: We aim to assess the factors associated with renal function preservation or decline in patients who underwent percutaneous renal cryoablation. Materials: In this IRB-approved HIPAA-compliant study, we performed a retrospective review of 39 percutaneous cryoablation procedures on renal tumors performed between April 2009 and August 2015 at our academic tertiary medical center. The following data were collected: patient
S39
demographics, BMI, prior medical history, prior surgical history, and characteristics of ablated lesion including lesion location and size. GFR was used as a surrogate marker of renal function and was collected at ablation, 1 month following ablation and 6 months following ablation. Linear regression was performed to assess for independent predictors of renal function at each time point following cryoablation. GFR was used as the outcome variable. The Wald test was used to assess for significant independent contribution of the assessed variables. Results: Of the 39 patients identified, 76% were male; 24% were female. The average patient age was 70.3 ⫾ 1.86 years. 13% of patients had prior radical nephrectomy; 23% of patients had prior partial nephrectomy. Of the lesions treated, 60% were in the right kidney and the average lesions size was 2.9 ⫾ 0.23 cm. The mean GFR at 1 month following ablation was 50.9 ⫾ 3.9 ml/min and 49.5 ⫾ 4 ml/min at 6 months following ablation. Linear regression with GFR as the outcome variable revealed that female sex (p ¼ 0.005), lack of history of radical nephrectomy (p ¼ 0.020) and smaller ablated lesion size (p ¼ 0.004) are independently significantly associated with higher GFR at 1 month post-cryoablation. Similarly, female sex (p ¼ 0.036) and smaller ablated lesion size (p ¼ 0.004) are associated with higher GFR at 6 months following renal cryoablation. Conclusions: Female sex and smaller ablated lesion size are independently associated with better renal function at 1 and 6 months following cryoablation. Lack of history of radical nephrectomy is associated with better GFR at 1 month following ablation. Review of these factors may improve pre-procedure patient counseling and personalize management decisions in patients undergoing renal cryoablation.
3:36 PM
Abstract No. 85
Analysis of the RENAL and mRENAL scores in the prediction of complications and local progression after percutaneous renal cryoablation J. McDevitt1, S. Mouli1, Y. Su1, A. Ragin1, Y. Gao1, A. Nemcek1, R. Lewandowski1, R. Salem1, K. Sato1; 1 Northwestern University Feinberg School of Medicine, Chicago, IL Purpose: Due to the uncertainty on the utility of the RENAL nephrometry score to predict complications and recurrence after percutaneous cryoablation, a modified RENAL (mRENAL) score has been proposed for radiofrequency ablation. Our purpose is to determine if the mRENAL score has any utility in predicting complications and recurrence after percutaneous cryoablation. Materials: We retrospectively reviewed primary masses treated with CT-guided percutaneous renal cryoablation between June 2007 and May 2016. The RENAL and mRENAL scores were used to stratify masses into low, medium, and high complexity tertiles. Complications were characterized by SIR criteria. Multivariate Logistic regression and Kaplan-Meier analysis were used to evaluate predictors of complications and local progression, respectively. Results: There were 95 renal cryoablation procedures on 86 patients. 89 of the ablations had at least one follow-up imaging
SUNDAY: Scientific Sessions
Purpose: To evaluate survival rates of Image-guided thermal ablation (TA) of pathologically proven T1a Renal cell carcinoma (RCC) in patients non-renal primaries. Materials: We reviewed patients with T1a RCC (o 4 cm) between 2005 and 2014 who underwent TA. We excluded patients with syndromes, and those with prior history of or bilateral RCC. We recorded: Demographics, any prior or current Cancer history, primary tumor histology and its status (remission or under therapy), local/systemic recurrence, survival/death and cause of death. Three groups were created based on primary status; patients with (A) RCC only, (B) other non-renal primary malignancy under treatment or (C) other non-renal primary malignancy in remission. Overall survival (OS) and disease free survival (DFS) were estimated using the Kaplan-Meier productlimit estimator and we conducted a log-rank test to compare the 3 groups. We also estimated the cumulative incidence of recurrence (CIR) by primary status using the methods of Gooley et al. Results: One hundred and ten TA for 109 lesions were performed in 109 patients (66 male and 43 females, average age 64 years). Groups (A), (B) and (C) were 46, 18 and 45 patients respectively. For groups (B) and (C), 56 patients had only 1 other primary cancer than RCC e.g. Hematological malignancies, colorectal, breast. Five and 3 patients had 2 and 3 other primary cancers, respectively. Post procedural recurrence developed in 3 patients (4%). None of the patient developed metastasis or died from RCC. The median OS and DFS were 8.39 and 6.57 years respectively with no statistical difference between 3 groups. One-, 3-, and 5-yr CIR for the whole population were 0.03 (95% CI: 0.01–0.07), 0.05 (95% CI: 0.02–0.10), 0.06 (95% CI: 0.03–0.13) respectively. Primary malignancies status was not significantly associated with increased risk of recurrence or disease. Conclusions: Image-guided TA is an effective treatment for T1a RCC in the setting of other non-renal malignancies. In our study, Primary malignancies status (in Remission or under therapy) did not have discernible impact on the thermal ablation effectiveness, OS, DFS or CIR.
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