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ABLATE: a score to predict complications and recurrence rate in percutaneous treatments of renal lesions

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Abstract

RENAL score has been validated on predicting adverse events and relapses in percutaneous treatments of renal lesions. To better fit interventional issues a modified score (mRENAL) has been introduced, but the only difference from the RENAL score is on the dimensional parameter. However, it remains of surgical derivation while a specific interventional score is missing. This study aims to obtain a specific score (ABLATE) to better quantify the risk of complications and relapses in percutaneous kidney ablation procedures compared to the existing surgical scores. Taking inspiration from previous papers, a score was built to quantify the real difficulties faced in percutaneous treatment of renal lesions. The ABLATE score was used on 71 cryoablations to evaluate its predictivity of complications and relapses. Logistic regression was used to predict complication incidence; Cox-regression was used for relapses; ROC analysis was used to evaluate the accuracy of the different scores. Between January 2014 and November 2019, 71 lesions in 68 patients were treated. Overall, malignant histology was found in 62 lesions (87.3%). Mean and median RENAL, mRENAL, and ABLATE scores were 7.04 and 7, 7.19 and 7, and 5.11 and 4, respectively. Out of 71 treatments, we experienced 3 bleeding with anemia (4.2%), only 2 of which needed further treatment (2.82%). The mean and median RENAL, mRENAL, and ABLATE scores in those with complications were 7.66 and 7.01 (p = 0.69), 8.0 and 7.1 (p = 0.54), and 6.6 and 5.0 (p = 0.38), respectively. Out of 62 malignant lesions, we experienced 2 persistent and 6 recurrent lesions (3.2% and 8.4%, respectively). At Cox-regression analyses, mABLATE score outperformed both RENAL and mRENAL scores in predicting recurrences (HR 1.48; p < 0.001 vs. 1.41; p = 0.1 vs. 1.38: p = 0.07, respectively). The ABLATE score showed to be a better predictor of relapses than RENAL and mRENAL. The small number of complications conditioned a lack of statistic power on complications for all the scores. At the moment to quantify the risks in percutaneous kidney ablation procedures, surgical scores are used. A specific score better performs this task.

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Authors and Affiliations

  1. Ospedale San Raffaele Sede di Ville Turro – UOC Radiology, Milan, Italy

    Maurizio Papa, Giulia Agostini & Gianpiero Cardone

  2. Ospedale San Raffaele Sede di Ville Turro – UOC Urology, Milan, Italy

    Nazareno Suardi, Andrea Losa, Tommaso Maga & Franco Gaboardi

  3. Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    Anna Maria Ierardi & Gianpaolo Carrafiello

Authors
  1. Maurizio Papa
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  2. Nazareno Suardi
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  3. Andrea Losa
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  4. Giulia Agostini
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  5. Tommaso Maga
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  7. Gianpaolo Carrafiello
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  9. Gianpiero Cardone
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Correspondence to Maurizio Papa.

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Papa, M., Suardi, N., Losa, A. et al. ABLATE: a score to predict complications and recurrence rate in percutaneous treatments of renal lesions. Med Oncol 37, 26 (2020). https://doi.org/10.1007/s12032-020-01351-3

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