3:27 PM Abstract No. 267 Efficacy of percutaneous image-guided thermal ablation for renal cell carcinoma following ipsilateral partial nephrectomy

Abstract

To evaluate the local efficacy of image-guided thermal ablation of renal cell carcinoma (RCC) after ipsilateral partial nephrectomy. We reviewed our institutional database for patients who underwent renal ablation for local recurrence in the ipsilateral kidney following partial nephrectomy between January 2005 and March 2019. We described demographics, tumor size, procedure details, complications, pathology and local oncologic outcome. Out of 710 renal ablations during the study period, a total of 35 patients (21 Males and 14 females) with a median age of 66 years met our inclusion criteria. Fifteen patients had a solitary kidney. Forty six procedures were performed for 52 lesions with average size of 2.3 cm (range, 0.8 – 4.5 cm). Four lesions were at the surgical margin. Pathology report revealed negative tumor margin in 3 patients, the fourth patient had surgery at another institution with no pathology report available. Of the 46 procedures, 42 were performed under CT and 4 were performed under MRI guidance. Of the 52 lesions, 43 were treated with RFA and 9 were treated with cryoablation. Technical success was obtained in all cases. Adjunctive Techniques; hydrodissection and pyeloperfusion were performed in 13 and 2 cases respectively. Four patients (11.5%) developed Clavien grade III complications. Of the 40 biopsied lesions, 36 samples were diagnostic (21 clear cell, 14 papillary, 1 hemangioma). Fuhrman grading was obtained in 29 lesions (grade 1 = 3, grade II = 22, grade III = 4). Median follow-up imaging was 4 years (0.5 – 11.5 years). Three lesions (5.7%) had residual/recurrence at the ablation site detected at 5.7, 6.6 and 7.3 months after ablation Thermal ablation is effective in treatment for RCC following ipsilateral partial nephrectomy. Long-term follow-up imaging reveals adequate local control in those patients.