PD07-08 CLINICAL OUTCOMES AND IMMUNE RESPONSE OF PERCUTANEOUS CRYOABLATION FOR LOCALIZED RENAL CELL CARCINOMA: EXPERIENCE IN CLINICAL PRACTICE IN JAPAN

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD07-08 CLINICAL OUTCOMES AND IMMUNE RESPONSE OF PERCUTANEOUS CRYOABLATION FOR LOCALIZED RENAL CELL CARCINOMA: EXPERIENCE IN CLINICAL PRACTICE IN JAPAN Taigo Kato, Yohei Okuda, Yusuke Ono, Hiroki Higashihara, Yu Ishizuya, Yoshiyuki Yamamoto, Koji Hatano, Atsunari Kawashima, and Norio Nonomura Taigo KatoTaigo Kato More articles by this author , Yohei OkudaYohei Okuda More articles by this author , Yusuke OnoYusuke Ono More articles by this author , Hiroki HigashiharaHiroki Higashihara More articles by this author , Yu IshizuyaYu Ishizuya More articles by this author , Yoshiyuki YamamotoYoshiyuki Yamamoto More articles by this author , Koji HatanoKoji Hatano More articles by this author , Atsunari KawashimaAtsunari Kawashima More articles by this author , and Norio NonomuraNorio Nonomura More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003231.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Partial nephrectomy has been recognized as the standard treatment for small renal cell carcinoma (sRCC) (<7 cm, cT1 tumor) because it provides optimal oncological outcomes and maintains better renal function than radical nephrectomy. On the other hand, with the increase of longevity, percutaneous cryoablation (PCA) for sRCC has been validated as an alternative nephron-sparing therapy especially in patients with comorbidity. However, there are only a few reports regarding long-term clinical outcome of PCA. METHODS: Of 112 patients who underwent CT-guided PCA at our hospital from June 2014 to December 2021, we retrospectively analyzed clinical data, oncological outcomes, and safety of PCA in 97 patients with sRCC without metastasis. In addition, we collected tissue samples before and at 3 months after treatment to evaluate the infiltration of immune cells. RESULTS: Of the 97 patients, 71 (73%) were treated as initial therapy for renal cancer and 26 (27%) as treatment for local recurrence of renal cancer. During a median follow-up of 36 months (3.5-96 months), 1 (1%) and 5 (5%) patients had residual cancer and recurrence, respectively. For survival analysis, PCA had 87 % of 5-year overall survival, 100% of 5-year cancer-specific survival, and 90% of 5-year local recurrence-free survival (Figure 1A-C). The mean eGFR of pre-PCA and at 3-month post-PCA were 52.8±1.92 ml/min and 48.3±1.92 ml/min, respectively. In logistic regression analysis, high R.E.N.A.L nephrotmetry score (>7) was associated with the decrease in eGFR of more than 20% (odds ratio 3.27, 95% confidence interval 0.95-11.27, p =0.04). The rate of severe complication (Grade 3) was 2.0%. Through the immunohistochemistry analysis of CD8 and CD11c on a subset of samples (Figure 1D), we confirmed the significant increase of infiltrated CD8 T and CD11c cells in post-PCA tissues. CONCLUSIONS: Our study demonstrated that PCA achieves a long-term local control with strong immune reactions. PCA appears to be a reasonable option for patients with high comorbidity at presentation. Source of Funding: Not available © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e165 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Taigo Kato More articles by this author Yohei Okuda More articles by this author Yusuke Ono More articles by this author Hiroki Higashihara More articles by this author Yu Ishizuya More articles by this author Yoshiyuki Yamamoto More articles by this author Koji Hatano More articles by this author Atsunari Kawashima More articles by this author Norio Nonomura More articles by this author Expand All Advertisement PDF downloadLoading ...