03:36 PM Abstract No. 87 Validation of R.E.N.A.L. nephrometry and PADUA scoring systems in percutaneous thermal ablation for renal cell carcinoma

Abstract

The aim of the study is to investigate the ability of R.E.N.A.L. nephrometry and PADUA scoring systems to predict the complications and survival outcomes in patients who underwent image-guided renal tumor ablation regardless of the ablation modality used. We retrospectively reviewed the medical records of 175 patients who had renal cell carcinoma that was treated with thermal (cryo, microwave or radiofrequency)or non-thermal (irreversible electroporation)ablation. The data on demographics, modality of ablation, tumor characteristics, and complications were reported. The RENAL and PADUA scores were calculated and patients were categorized accordingly. Technical success and complications were analyzed. Kaplan Meier curves for recurrence free, cancer specific and overall survival were generated. The study included 175 patients with 177 tumors, 104 (59.4%) males, with a mean age of 64.7 (SD=11.5) years. There were 53 (30.3%) patients with CKD stage 3. Percutaneous cryoablation was performed in 128 (73%), microwave ablation in 29 (16.6%), radiofrequency ablation in 12 (6.8%) and Irreversible Electroporation in 6 (3.4%) patients. Mean tumor size was 3.04 (SD=1.3) cm, with 75 tumors (42.4%) located posteriorly. RENAL score was low, moderate and high in 90 (51.1%), 72 (40.9%) and 14 (8%) patients respectively. PADUA score was 6-7, 8-9 and ≥10 in 69 (39.2%), 68 (38.6%) and 39 (22.2%) patients respectively. Technical success was seen in 159 (90.9%) patients. Thirty-day complications was 27.9%. Recurrence free and overall survival at 1 year was 92.7% and 97.6% respectively. There was no correlation between the RENAL and PADUA scores with the occurrence of complications, recurrence free survival or overall survival. The nearness of the tumor to the collecting system and biopsy before the procedure correlated with the occurrence of complications (p=0.03 and p=0.02 respectively). RENAL and PADUA scores do not correlate with the occurrence of complications, recurrence free survival or overall survival in patients with renal cell carcinoma treated with percutaneous ablation. The nearness to the collecting system and tumor biopsy correlated with the occurrence of complications.