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Impact of tumor histology and grade on treatment success of percutaneous renal cryoablation

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Abstract

Background

We analyzed oncological outcomes in patients who underwent percutaneous renal cryoablation (PRC) with documented renal cell carcinoma (RCC) by perioperative biopsy.

Methods

Multicenter retrospective analysis of 153 patients [median follow-up 48 months] who underwent PRC from 09/2005 to 08/2014 was performed. We divided the cohort into patients who developed recurrence versus no recurrence. Kaplan–Meier analyses examined recurrence-free survival (RFS) according to grade and histology. Multivariable analysis (MVA) was performed to identify factors associated with tumor recurrence.

Results

One hundred and fifty-three patients were analyzed [18 patients (11.8 %) with recurrence and 135 (88.2 %) patients without recurrence]. There were no differences between the groups with respect to demographics, RENAL score, and number of probes utilized. Recurrence group had larger tumor size (3.1 vs. 2.4 cm; p = 0.011), upper pole tumor location (p = 0.016), and greater proportions of high-grade tumor (33 vs. 0.7 %; p < 0.001) and clear cell histology (77.8 vs. 45.9 %; p = 0.011). Four-year RFS was 100 versus 80 % for grade 1 versus grade 2/3 tumors (p = 0.0002), and 97 versus 88 % for other RCC versus clear cell RCC (p = 0.07). MVA demonstrated tumor size >3 cm (OR 2.46; p = 0.019), clear cell histology (OR 2.12; p = 0.027), and high tumor grade (OR 2.33, p < 0.001) as independent risk factors associated with tumor recurrence.

Conclusions

Association of higher grade and clear cell histology with recurrence and progression suggests need for increased emphasis on preoperative risk stratification by biopsy, with grade 1 and non-clear cell RCC being associated with improved treatment success than higher grade and clear cell RCC.

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Funding

Stephen Weissman Kidney Cancer Research Fund.

Authors’ contribution

Beksac was involved in data collection and manuscript writing/editing. Rivera-Sanfeliz and Derweesh were involved in protocol/project development and manuscript writing/editing. Dufour was involved in data collection and data analysis. Nseyo was involved in data collection and data management. Hamilton was involved in data analysis and manuscript writing/editing. Berquist was involved in data collection, data management, and project development. Hassan collected the data and developed the project. Raheem was involved in data collection and manuscript writing. Wang was involved in data collection/management and data analysis. Wake was involved in protocol development, data collection, and data management. Gold was involved in protocol development and manuscript editing.

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Authors and Affiliations

  1. Department of Urology, Moores UCSD Cancer Center, University of California San Diego School of Medicine, 3855 Health Sciences Drive, Mail Code: 0987, La Jolla, CA, 92093-0987, USA

    Alp Tuna Beksac, Catherine A. Dufour, Unwanaobong Nseyo, Zachary Hamilton, Sean W. Berquist, Abd-elRahman Hassan, Omer A. Raheem, Song Wang & Ithaar H. Derweesh

  2. Department of Radiology, University of California San Diego School of Medicine, La Jolla, CA, USA

    Gerant Rivera-Sanfeliz

  3. Department of Urology, University of Tennessee Health Science Center, Memphis, TN, USA

    Robert W. Wake

  4. Department of Radiology, University of Tennessee Health Science Center, Memphis, TN, USA

    Robert E. Gold

Authors
  1. Alp Tuna Beksac
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  2. Gerant Rivera-Sanfeliz
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  3. Catherine A. Dufour
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  4. Unwanaobong Nseyo
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  5. Zachary Hamilton
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  7. Abd-elRahman Hassan
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  8. Omer A. Raheem
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  9. Song Wang
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  10. Robert W. Wake
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  11. Robert E. Gold
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  12. Ithaar H. Derweesh
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Corresponding author

Correspondence to Ithaar H. Derweesh.

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None of the authors have any conflict of interest to declare.

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Have been met; study is IRB approved at both institutions.

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Beksac, A.T., Rivera-Sanfeliz, G., Dufour, C.A. et al. Impact of tumor histology and grade on treatment success of percutaneous renal cryoablation. World J Urol 35, 633–640 (2017). https://doi.org/10.1007/s00345-016-1911-6

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  • DOI: https://doi.org/10.1007/s00345-016-1911-6

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