MP47-08 PERCUTANEOUS THERMAL ABLATION IS SAFE AND FEASIBLE FOR IPSILATERAL LOCAL RECURRENCE OF DISEASE AFTER PARTIAL NEPHRECTOMY FOR RENAL CELL CARCINOMA

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP47-08 PERCUTANEOUS THERMAL ABLATION IS SAFE AND FEASIBLE FOR IPSILATERAL LOCAL RECURRENCE OF DISEASE AFTER PARTIAL NEPHRECTOMY FOR RENAL CELL CARCINOMA Justin Refugia, Tarek Taha, Ayelet Wandel, Nidal Edkaedek, Alexander Tsivian, Parth Thakker, Jacob Bundy, Sarah Connolly, Michael Miller, and Matvey Tsivian Justin RefugiaJustin Refugia More articles by this author , Tarek TahaTarek Taha More articles by this author , Ayelet WandelAyelet Wandel More articles by this author , Nidal EdkaedekNidal Edkaedek More articles by this author , Alexander TsivianAlexander Tsivian More articles by this author , Parth ThakkerParth Thakker More articles by this author , Jacob BundyJacob Bundy More articles by this author , Sarah ConnollySarah Connolly More articles by this author , Michael MillerMichael Miller More articles by this author , and Matvey TsivianMatvey Tsivian More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003293.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Utilization of non-surgical modalities to manage local recurrence (LR) of renal mass after partial nephrectomy (PN) is paramount. Recurrence has been reported up 3.2% during the surveillance period. Repeat PN for an ipsilateral recurrence, while feasible, can be technically challenging with upwards of a 19.6% major perioperative complication rate. Percutaneous thermal ablation (PTA) for LR is a nephron-sparing procedure that is a viable option in this setting. In this study, we present our experience with LR of renal mass after PN to assess perioperative and oncologic outcomes. METHODS: We reviewed a retrospective case series of patients in two institutions who had LR after PN for RCC and were managed with PTA. LR was defined as enhancing renal mass ipsilateral to prior PN. The primary objectives were post-ablation recurrence free survival (RFS) and complication rate. A descriptive analysis was performed of the data collected. Kaplan-Meier survival analysis was performed to assess recurrence free survival after TA for LR. RESULTS: We identified 27 patients between 2012 and 2022 that were treated percutaneously with cryoablation (37%), radiofrequency ablation (33%) or microwave ablation (30%). The patients had a combined 34 tumors removed by PN, primarily T1a (70%) or T1b (15%), with clear cell (59%) or papillary (29%) subtype. There were positive surgical margins at PN in 33% of patients. LR occurred at median of 4 years after PN with a median size of 1.7 cm. Five tumors (17%) recurred at the PN site and the remainder were de novo tumors. Two patients (7%) developed perinephric hematoma immediately post-procedure that was managed conservatively (Clavien-Dindo Grade 1). Surveillance imaging was performed according to international management guidelines. Following PTA, there were 4 ipsilateral recurrences (13%) at a median of 14 months. One patient required repeat ablation for an ipsilateral tumor. RFS after PTA for LR was 93%, 79%, and 63% at 1 years, 2 years, and 5 years, respectively. CONCLUSIONS: Our data demonstrate that local therapy with PTA for local recurrence after PN is safe and feasible. Further comparisons of local therapies for management of LR after partial nephrectomy may reinforce the use of PTA for small renal masses. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e646 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Justin Refugia More articles by this author Tarek Taha More articles by this author Ayelet Wandel More articles by this author Nidal Edkaedek More articles by this author Alexander Tsivian More articles by this author Parth Thakker More articles by this author Jacob Bundy More articles by this author Sarah Connolly More articles by this author Michael Miller More articles by this author Matvey Tsivian More articles by this author Expand All Advertisement PDF downloadLoading ...