PD46-03 EVALUATION OF SKIN-TO-TUMOR DISTANCE AS A PREDICTOR OF TUMOR RECURRENCE FOLLOWING PERCUTANEOUS CRYOABLATION OF RENAL CORTICAL NEOPLASMS

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Ablative Therapy & Active Surveillance1 Apr 2016PD46-03 EVALUATION OF SKIN-TO-TUMOR DISTANCE AS A PREDICTOR OF TUMOR RECURRENCE FOLLOWING PERCUTANEOUS CRYOABLATION OF RENAL CORTICAL NEOPLASMS Simone L Vernez, Zhamshid Okhunov, Rahul Dutta, Kamaljot Kaler, Arvin George, Daniel Moreira, Louis Kavoussi, Ralph V Clayman, and Jaime Landman Simone L VernezSimone L Vernez More articles by this author , Zhamshid OkhunovZhamshid Okhunov More articles by this author , Rahul DuttaRahul Dutta More articles by this author , Kamaljot KalerKamaljot Kaler More articles by this author , Arvin GeorgeArvin George More articles by this author , Daniel MoreiraDaniel Moreira More articles by this author , Louis KavoussiLouis Kavoussi More articles by this author , Ralph V ClaymanRalph V Clayman More articles by this author , and Jaime LandmanJaime Landman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2395AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Percutaneous cryoablation (PCA) is a minimally invasive, nephron-sparing treatment for small renal masses (SRM). We evaluated the impact of skin-to-tumor distance on risk for recurrent disease following PCA. METHODS We retrospectively reviewed patients who underwent PCA for SRM at two academic centers between 2005 and 2015. We recorded and analyzed patient demographics and tumor characteristics including tumor size, location and the R.E.N.A.L. Nephrometry score. We measured the skin-to-tumor (STT), and skin- to-hilum (STH) distance by averaging the distance from skin to center of tumor or edge of hilum at 0, 45 and 90 degrees on preoperative imaging. Descriptive statistics were used to describe age, gender, American Society of Anesthesiologists (ASA) scores, body mass index (BMI), tumor size, location and pathology. Logistic regression was used to identify the relationship between pre and perioperative variables and recurrence. RESULTS We included a total of 169 patients. Demographic and clinical characteristics and histopathology of recurrence and non-recurrence groups are demonstrated in Table 1. With a mean follow up of 24 months, 12 (7%) tumor recurrences occurred. Patients with tumor recurrences had significantly higher STT (mean 10.9 cm and 8.4 cm, respectively; p=0.0001). On multivariate logistic regression analysis, STT was an independent predictor of tumor recurrence (p= 0.03). For every centimeter increase in STT, there was a 1.36 increase in the odds of recurrence in patients undergoing PCA (CI 1.06-1.663, p= 0.003). STH, BMI, tumor size, R.E.N.A.L. score, number of probes and age at time of surgery were not significantly associated with recurrence (Table 2). All recurrences were treated with either repeat cryoablation or laparoscopic partial nephrectomy for their recurrent tumor. CONCLUSIONS STT distance is an easily measured preoperative variable associated with increased risk of recurrence and should be taken into consideration during planning prior to PCA. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1124 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Simone L Vernez More articles by this author Zhamshid Okhunov More articles by this author Rahul Dutta More articles by this author Kamaljot Kaler More articles by this author Arvin George More articles by this author Daniel Moreira More articles by this author Louis Kavoussi More articles by this author Ralph V Clayman More articles by this author Jaime Landman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...