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Image-Guided Thermal Ablation for Non-resectable Recurrence of Renal Cell Cancer Following Nephrectomy: Clinical Experience with Eleven Patients

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Abstract

Purpose

To assess the feasibility, safety and clinical outcomes of image-guided percutaneous thermal ablation as salvage therapy for local recurrence of renal cell carcinoma (RCC) in patients initially treated surgically with curative intent.

Materials and Methods

A retrospective review of 11 consecutive patients (M/F = 8:3, mean age = 76 years) who underwent computed tomography (CT)-guided thermal ablation for locally recurrent RCC after partial (72%, 8/11) or radical nephrectomy (28%, 3/11) with a mean time to recurrence of 48 months (range 2–156). Assessment of technical success, complication (peri- and post-procedural), oncological outcome and survival analysis were performed. Patient baseline and follow-up renal function surrogates including creatinine level (Cr) and estimated glomerular filtration rate (eGFR) were statistically compared.

Results

Eleven biopsy-proven recurrent RCC measuring 1.4–3.9 cm (mean = 2.8 cm) were treated with CT-guided thermal ablation. Technical success was achieved in 100% (11/11) of the cases. There were no major complications except for one (9%) asymptomatic hemorrhage (Clavien–Dindo grade I complication). Complete response, local progression-free and overall survival rate were 91, 91 and 82% during the mean follow-up time of 2.5 years (range 0.1–7.1). Renal function was overall stable without significant change at 1 month and last follow-up (p = 0.21; GFR, p = 0.10; creatinine).

Conclusions

Image-guided percutaneous thermal ablation is a feasible, safe and effective for local recurrence after nephrectomy, representing a non-surgical alternative for unresectable disease.

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Authors and Affiliations

  1. Tufts University School of Medicine, 145 Harrison Avenue, Boston, MA, 02111, USA

    Wenhui Zhou & Sanna E. Herwald

  2. Department of Radiology, Division of Interventional Radiology, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, GRB 293, Boston, MA, 02114, USA

    Raul N. Uppot & Ronald S. Arellano

Authors
  1. Wenhui Zhou
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  2. Sanna E. Herwald
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  3. Raul N. Uppot
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  4. Ronald S. Arellano
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Corresponding author

Correspondence to Ronald S. Arellano.

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Zhou, W., Herwald, S.E., Uppot, R.N. et al. Image-Guided Thermal Ablation for Non-resectable Recurrence of Renal Cell Cancer Following Nephrectomy: Clinical Experience with Eleven Patients. Cardiovasc Intervent Radiol 41, 1743–1750 (2018). https://doi.org/10.1007/s00270-018-1976-2

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  • DOI: https://doi.org/10.1007/s00270-018-1976-2

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