Irreversible electroporation of small renal masses: suboptimal oncologic efficacy in an early series
To report on the first short-term oncologic outcomes of percutaneous irreversible electroporation for small renal masses.
Patients with cT1a renal masses treated with irreversible electroporation from April 2013 through December 2016 were reviewed. Small, low complexity tumors were generally selected for irreversible electroporation using the NanoKnife® System (Angiodynamics, Latham, NY, USA). Surveillance imaging was performed post-operatively, and survival analysis was completed using the Kaplan–Meier method.
A total of 42 tumors in 41 patients underwent irreversible electroporation. Mean tumor size was 2.0 cm with a median R.E.N.A.L nephrometry score of 5. Twenty-nine patients (71%) were discharged the same day of the procedure and no major (Clavien grade II or higher) intraoperative or post-operative complications occurred. Initial treatment success rate was 93%; our three failures (7%) underwent salvage radiofrequency ablation. With a mean follow-up of 22 months, 2-year local recurrence-free survival was 83% for patients with biopsy confirmed renal cell carcinoma, 87% with biopsy confirmed or a history of renal cell carcinoma, and 92% for the intent-to-treat cohort.
Although with low morbidity, in comparison to extirpation and conventional thermal ablation technologies, irreversible electroporation has suboptimal short-term local disease control results in this series of small, low complexity tumors. Larger series and longer follow-up will determine the durability of this modality.
KeywordsKidney neoplasms Carcinoma Renal cell Electroporation Survival rate Complications
Compliance with ethical standards
NEC: Data collection, Data analysis, Manuscript writing and editing. IS: Data collection, Data analysis, Manuscript writing and editing. AHL: Data collection. MSCM: Data collection, Manuscript writing. AO: Data collection. CT: Protocol/project development. JAC: Protocol/project development, Data analysis, Manuscript editing.
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in this study were in accordance with the ethical standards of the Institutional Review Board and with the 1964 Helsinki declaration and its later amendments.
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