Skip to main content

Advertisement

SpringerLink
Log in

sABLATE: a simplified ABLATE score for prediction of complications and outcome in percutaneous thermal ablation of renal lesions

  • Original Paper
  • Published:
Medical Oncology Aims and scope Submit manuscript

Abstract

The aim of the study is to evaluate the performance of a simplified ABLATE score (sABLATE) in predicting complications and outcome with respect to RENAL, mRENAL, and ABLATE scores. This study included 136 renal lesions in 113 patients (M:F ratio = 2.5; mean age 70.8 years). 98 tumors underwent cryoablation at San Raffaele hospital between 01/2015 and 03/2020, while 37 underwent microwave ablation at San Paolo or Policlinico hospitals between 07/2016 and 03/2020. RENAL, mRENAL, ABLATE, and sABLATE scores were calculated using pre-procedural imaging. Data regarding complications and follow-up were registered. Mann–Whitney U test, ROC analyses, and logistic regression analyses were used for complications. Cox-regression analyses were performed for outcome. Mean tumor diameter was 23.2 mm. Mean and median RENAL, mRENAL, ABLATE, and sABLATE scores were 6.8 and 7, 6.9 and 7, 5.3, and 5, and 3.5 and 3, respectively. During a mean follow-up of 21.9 months (range 1–73), we registered 7 complications, 3 cases of residual disease, and 10 local tumor progressions. Mann–Whitney U test p values for complications for RENAL, mRENAL, ABLATE, and sABLATE were 0.51, 0.49, 0.66, and 0.056, respectively. ROC analyses for complications showed an AUC for RENAL, mRENAL, ABLATE, and sABLATE of 0.57, 0.57, 0.55, and 0.71, respectively. Regarding outcome, HR and p values of Cox-regression analyses were 1.30 and 0.36 for RENAL, 1.33 and 0.35 for mRENAL, 2.16 and 0.01 for ABLATE, 2.29 and 0.004 for sABLATE. sABLATE was the only score close to significance for complications, representing a progress even if not definitive. Regarding outcome, ABLATE confirmed its value, and sABLATE maintained validity despite being a simplification.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Hollingsworth JM, Miller DC, Daignault S, Hollenbeck BK. Rising incidence of small renal masses: a need to reassess treatment effect. J Natl Cancer Inst. 2006;98(18):1331–4.

    Article  Google Scholar 

  2. Znaor A, Lortet-Tieulent J, Laversanne M, Jemal A, Bray F. International variations and trends in renal cell carcinoma incidence and mortality. Eur Urol. 2015;67(3):519–30.

    Article  Google Scholar 

  3. Shah PH, Alom MA, Leibovich BC, et al. The temporal association of robotic surgical diffusion with overtreatment of the small renal mass. J Urol. 2018;200(5):981–8.

    Article  Google Scholar 

  4. Iannuccilli JD, Dupuy DE, Beland MD, Machan JT, Golijanin DJ, Mayo-Smith W. Effectiveness and safety of computed tomography-guided radiofrequency ablation of renal cancer: a 14-year single institution experience in 203 patients. Eur Radiol. 2016;26(6):1656–64.

    Article  Google Scholar 

  5. Yang Y, Chen S, Chen F, et al. Outcome of radiofrequency ablation over partial nephrectomy for small renal mass. Int J Clin Exp Med. 2015;8(11):20670–4.

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Trudeau V, Larcher A, Boehm K, et al. Comparison of postoperative complications and mortality between laparoscopic and percutaneous local tumor ablation for T1a renal cell carcinoma: a population-based study. Urology. 2016;89:63–8.

    Article  Google Scholar 

  7. Larcher A, Trudeau V, Sun M, et al. Population-based assessment of cancer-specific mortality after local tumour ablation or observation for kidney cancer: a competing risks analysis. BJU Int. 2016;118(4):541–6.

    Article  Google Scholar 

  8. Yu J, Zhang G, Liang P, et al. Midterm results of percutaneous microwave ablation under ultrasound guidance versus retroperitoneal laparoscopic radial nephrectomy for small renal cell carcinoma. Abdom Imaging. 2015;40(8):3248–56.

    Article  Google Scholar 

  9. Pierorazio PM, Johnson MH, Patel HD, et al. Management of renal masses and localized renal cancer: systematic review and meta-analysis. J Urol. 2016;196(4):989–99.

    Article  Google Scholar 

  10. Thompson RH, Atwell T, Schmit G, et al. Comparison of partial nephrectomy and percutaneous ablation for cT1 renal masses. Eur Urol. 2015;67(2):252–9.

    Article  Google Scholar 

  11. Whitson JM, Harris CR, Meng MV. Population-based comparative effectiveness of nephron-sparing surgery vs ablation for small renal masses. BJU Int. 2012;110(10):1438–43.

    Article  Google Scholar 

  12. Campbell S, Uzzo RG, Allaf ME, et al. Renal mass and localized renal cancer: AUA guideline. J Urol. 2017;198(3):520–9.

    Article  Google Scholar 

  13. Finelli A, Ismaila N, Bro B, et al. Management of small renal masses: American society of clinical oncology clinical practice guideline. J Clin Oncol. 2017;35(6):668–80.

    Article  Google Scholar 

  14. Motzer RJ, Jonasch E, Agarwal N, et al. Kidney cancer, version 2.2017: clinical practice guidelines in oncology. JNCCN J Natl Compr Cancer Netw. 2017;15(6):804–34.

    Article  Google Scholar 

  15. Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009;182(3):844–53.

    Article  Google Scholar 

  16. Schmit GD, Thompson RH, Kurup AN, et al. Usefulness of R.E.N.A.L. nephrometry scoring system for predicting outcomes and complications of percutaneous ablation of 751 renal tumors. J Urol. 2013;189(1):30–5.

    Article  Google Scholar 

  17. Camacho JC, Kokabi N, Xing M, et al. R.E.N.A.L. (radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, and location relative to polar lines) nephrometry score predicts early tumor recurrence and complications after percutaneous ablative therapies for renal cell carcinoma: a 5-year experience. J Vasc Interv Radiol. 2015;26(5):686–93.

    Article  Google Scholar 

  18. Sisul DM, Liss MA, Palazzi KL, et al. RENAL nephrometry score is associated with complications after renal cryoablation: a multicenter analysis. Urology. 2013;81(4):775–80.

    Article  Google Scholar 

  19. Ierardi AM, Puliti A, Angileri SA, et al. Microwave ablation of malignant renal tumours: intermediate-term results and usefulness of RENAL and mRENAL scores for predicting outcomes and complications. Med Oncol. 2017;34(5):97.

    Article  Google Scholar 

  20. Kim EH, Tanagho YS, Bhayani SB, Saad NE, Benway BM, Figenshau RS. Percutaneous cryoablation of renal masses: Washington University experience of treating 129 tumours. BJU Int. 2013;111(6):872–9.

    Article  Google Scholar 

  21. Seideman CA, Gahan J, Weaver M, et al. Renal tumour nephrometry score does not correlate with the risk of radiofrequency ablation complications. BJU Int. 2013;112(8):1121–4.

    Article  Google Scholar 

  22. Gahan JC, Richter MD, Seideman CA, et al. The performance of a modified RENAL nephrometry score in predicting renal mass radiofrequency ablation success. Urology. 2015;85(1):125–9.

    Article  Google Scholar 

  23. 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. 2020;37(4):26.

    Article  CAS  Google Scholar 

  24. Rothman J, Crispen PL, Wong YN, Al-Saleem T, Fox E, Uzzo RG. Pathologic concordance of sporadic synchronous bilateral renal masses. Urology. 2008;72(1):138–42.

    Article  Google Scholar 

  25. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.

    Article  Google Scholar 

  26. Ahmed M, Solbiati L, Brace CL, et al. Image-guided tumorablation: standardization ofterminology and reporting criteria-A 10-year update. J Vasc Interv Radiol. 2014;25(11):1691-1705.e4.

    Article  Google Scholar 

  27. Zargar H, Atwell TD, Cadeddu JA, et al. Cryoablation for small renal masses: selection criteria, complications, and functional and oncologic results. Eur Urol. 2016;69(1):116–28.

    Article  Google Scholar 

  28. Klapperich ME, Abel EJ, Ziemlewicz TJ, et al. Effect of tumor complexity and technique on efficacy and complications after percutaneous microwave ablation of stage T1a renal cell carcinoma: a single-center, retrospective study. Radiology. 2017;284(1):272–80.

    Article  Google Scholar 

  29. De Cobelli F, Papa M, Panzeri M, et al. Percutaneous microwave ablation versus cryoablation in the treatment of T1a renal tumors. Cardiovasc Interv Radiol. 2020;43(1):76–83.

    Article  Google Scholar 

  30. Maciolek KA, Abel EJ, Posielski NM, et al. Tumor location does not impact oncologic outcomes for percutaneous microwave ablation of clinical T1a renal cell carcinoma. Eur Radiol. 2019;29(11):6319–29.

    Article  Google Scholar 

  31. Zhou W, Herwald SE, McCarthy C, Uppot RN, Arellano RS. Radiofrequency ablation, cryoablation, and microwave ablation for T1a renal cell carcinoma: a comparative evaluation of therapeutic and renal function outcomes. J Vasc Interv Radiol. 2019;30(7):1035–42.

    Article  Google Scholar 

  32. Kim DK, Won JY, Park SY. Percutaneous cryoablation for renal cell carcinoma using ultrasound-guided targeting and computed tomography-guided ice-ball monitoring: radiation dose and short-term outcomes. Acta radiol. 2019;60(6):798–804.

    Article  Google Scholar 

  33. Yamanaka T, Yamakado K, Yamada T, et al. CT-guided percutaneous cryoablation in renal cell carcinoma: factors affecting local tumor control. J Vasc Interv Radiol. 2015;26(8):1147–53.

    Article  Google Scholar 

  34. Beksac AT, Rivera-Sanfeliz G, Dufour CA, et al. Impact of tumor histology and grade on treatment success of percutaneous renal cryoablation. World J Urol. 2017;35(4):633–40.

    Article  Google Scholar 

  35. Haddad MM, Schmit GD, Kurup AN, et al. Percutaneous cryoablation of solitary, sporadic renal cell carcinoma: outcome analysis based on clear-cell versus papillary subtypes. J Vasc Interv Radiol. 2018;29(8):1122–6.

    Article  Google Scholar 

Download references

Acknowledgements

We thank Giacomo Mason, PhD, who provided statistical support and expertise for this research.

Funding

No funding was received for conducting this study.

Author information

Authors and Affiliations

  1. Azienda Socio Sanitaria Territoriale (ASST) Lodi, Complex Unit of Radiology, Department of Diagnostic and Interventional Radiology, Viale Savoia 4, 26900, Lodi, Italy

    Maurizio Papa & Paola Scagnelli

  2. Diagnostic and Interventional Radiology Department, IRCCS Cà Granda Fondazione Ospedale Maggiore Policlinico, Università degli studi di Milano, Milan, Italy

    Pierpaolo Biondetti, Roberta Colombo, Anna Maria Ierardi, Salvatore Alessio Angileri & Gianpaolo Carrafiello

  3. Urology Department, IRCCS Cà Granda Fondazione Ospedale Maggiore Policlinico, Università degli studi di Milano, Milan, Italy

    Gianpaolo Lucignani, Luca Boeri & Emanuele Montanari

  4. Diagnostic and Interventional Radiology Department, IRCCS Ospedale San Raffaele—Turro, Università Vita—Salute San Raffaele, Milan, Italy

    Gianpiero Cardone

Authors
  1. Maurizio Papa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pierpaolo Biondetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Roberta Colombo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anna Maria Ierardi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Salvatore Alessio Angileri
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gianpaolo Lucignani
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Luca Boeri
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Emanuele Montanari
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Gianpiero Cardone
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Paola Scagnelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Gianpaolo Carrafiello
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

We declare that all authors have significantly contributed to all the steps of this research project, from ideation to final manuscript review. All authors have read and agreed to the submitted version of the manuscript.

Corresponding author

Correspondence to Maurizio Papa.

Ethics declarations

Conflict of interest

The authors have no conflict of interest to declare that are relevant to the content of this article.

Ethical approval

Ethical approval was given by IRBs/ Ethical approval was waived by IRB in view of the retrospective nature of the study and all the procedures performed were part of the routine care. The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Consent to participate

Waived by IRB for this retrospective study, which is observational and didn’t modify the routine care in any way.

Consent for publication

Waived by IRB as no identifying information is present in the current study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Papa, M., Biondetti, P., Colombo, R. et al. sABLATE: a simplified ABLATE score for prediction of complications and outcome in percutaneous thermal ablation of renal lesions. Med Oncol 38, 126 (2021). https://doi.org/10.1007/s12032-021-01542-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12032-021-01542-6

Keywords

Search

Navigation