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Microwave ablation of malignant renal tumours: intermediate-term results and usefulness of RENAL and mRENAL scores for predicting outcomes and complications.

Abstract The aim of this study was to evaluate intermediate-term results after microwave ablation (MWA) of renal tumours and determine the association of RENAL and modified RENAL (mRENAL) scores with oncological outcomes and complications. In May 2008-September 2014, 58 patients affected by early-stage RCC (renal cell carcinoma; T1a or T1b) were judged unsuitable for surgery and treated with percutaneous MWA. Follow-up was performed with contrast-enhanced computed tomography at 1, 3, 6, 12 and 24 months after the procedure. Technical success (TS), primary technical effectiveness (PTE), secondary technical effectiveness (STE), the local tumour progression rate (LTPR), the cancer-specific survival rate (CSSR), disease-free survival (DFS), overall survival (OS) and safety were recorded. All lesions were evaluated using RENAL and mRENAL scores, and complications were assessed with RENAL scores. The TS rate was 100%, PTE was 93%, STE was 100%, LTPR was 15.7% at 1 year, CSSR was 96.5%, DFS was 87.9% at 5 years, and OS was 80.6%. Mean follow-up was 25.7 months (range 3-72). The mean ± standard deviation (SD) RENAL and mRENAL scores of all treated tumours were 6.7 ± 2.05 (range 4-11) and 7 ± 2.3 (range 4-12), respectively. Major complications occurred in two (2/58) and minor complications in three patients (3/58). Overall complications correlated significantly with RENAL scores; in particular, E and L represent negative predictors for safety and effectiveness. MWA is a valuable alternative for treating RCCs. The correlation with outcomes and complications of RENAL and mRENAL scores could help to customise MWA indications in RCC patients.
PMID
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Authors

Mayor MeshTerms
Keywords

Complementary therapies

Complications

Induced hyperthermia

Microwave ablation

Renal cancer

Journal Title medical oncology (northwood, london, england)
Publication Year Start




PMID- 28421553
OWN - NLM
STAT- MEDLINE
DA  - 20170419
DCOM- 20170419
LR  - 20170419
IS  - 1559-131X (Electronic)
IS  - 1357-0560 (Linking)
VI  - 34
IP  - 5
DP  - 2017 May
TI  - Microwave ablation of malignant renal tumours: intermediate-term results and
      usefulness of RENAL and mRENAL scores for predicting outcomes and complications.
PG  - 97
LID - 10.1007/s12032-017-0948-8 [doi]
AB  - The aim of this study was to evaluate intermediate-term results after microwave
      ablation (MWA) of renal tumours and determine the association of RENAL and
      modified RENAL (mRENAL) scores with oncological outcomes and complications. In
      May 2008-September 2014, 58 patients affected by early-stage RCC (renal cell
      carcinoma; T1a or T1b) were judged unsuitable for surgery and treated with
      percutaneous MWA. Follow-up was performed with contrast-enhanced computed
      tomography at 1, 3, 6, 12 and 24 months after the procedure. Technical success
      (TS), primary technical effectiveness (PTE), secondary technical effectiveness
      (STE), the local tumour progression rate (LTPR), the cancer-specific survival
      rate (CSSR), disease-free survival (DFS), overall survival (OS) and safety were
      recorded. All lesions were evaluated using RENAL and mRENAL scores, and
      complications were assessed with RENAL scores. The TS rate was 100%, PTE was 93%,
      STE was 100%, LTPR was 15.7% at 1 year, CSSR was 96.5%, DFS was 87.9% at 5 years,
      and OS was 80.6%. Mean follow-up was 25.7 months (range 3-72). The mean +/-
      standard deviation (SD) RENAL and mRENAL scores of all treated tumours were 6.7
      +/- 2.05 (range 4-11) and 7 +/- 2.3 (range 4-12), respectively. Major
      complications occurred in two (2/58) and minor complications in three patients
      (3/58). Overall complications correlated significantly with RENAL scores; in
      particular, E and L represent negative predictors for safety and effectiveness.
      MWA is a valuable alternative for treating RCCs. The correlation with outcomes
      and complications of RENAL and mRENAL scores could help to customise MWA
      indications in RCC patients.
FAU - Ierardi, Anna Maria
AU  - Ierardi AM
AD  - Department of Diagnostic and Interventional Radiology, San Paolo Hospital,
      University of Milan, Via A. Di Rudini, 8, 20142, Milan, MI, Italy.
FAU - Puliti, Alessio
AU  - Puliti A
AD  - Department of Diagnostic and Interventional Radiology, San Paolo Hospital,
      University of Milan, Via A. Di Rudini, 8, 20142, Milan, MI, Italy.
FAU - Angileri, Salvatore Alessio
AU  - Angileri SA
AD  - Department of Diagnostic and Interventional Radiology, San Paolo Hospital,
      University of Milan, Via A. Di Rudini, 8, 20142, Milan, MI, Italy.
FAU - Petrillo, Mario
AU  - Petrillo M
AD  - Department of Diagnostic and Interventional Radiology, San Paolo Hospital,
      University of Milan, Via A. Di Rudini, 8, 20142, Milan, MI, Italy.
      [email protected]
FAU - Duka, Ejona
AU  - Duka E
AD  - Department of Radiology, Ospedale di Circolo e Fondazione Macchi, University of
      Insubria, Viale Borri 57, 21100, Varese, VA, Italy.
FAU - Floridi, Chiara
AU  - Floridi C
AD  - Department of Radiology, Ospedale Fatebenefratelli e Oftalmico, ASST
      Fatebenefratelli Sacco, Corso di Porta Nuova, 23, 20121, Milan, MI, Italy.
FAU - Lecchi, Michela
AU  - Lecchi M
AD  - Department of Health Physics, San Paolo Hospital, University of Milan, Via A. Di 
      Rudini, 8, 20142, Milan, MI, Italy.
FAU - Carrafiello, Gianpaolo
AU  - Carrafiello G
AD  - Department of Diagnostic and Interventional Radiology, San Paolo Hospital,
      University of Milan, Via A. Di Rudini, 8, 20142, Milan, MI, Italy.
LA  - eng
PT  - Journal Article
DEP - 20170419
PL  - United States
TA  - Med Oncol
JT  - Medical oncology (Northwood, London, England)
JID - 9435512
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma, Renal Cell/pathology/*surgery
MH  - Catheter Ablation/adverse effects/*methods
MH  - Female
MH  - Humans
MH  - Kidney Neoplasms/pathology/*surgery
MH  - Male
MH  - Microwaves/*therapeutic use
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Complementary therapies
OT  - Complications
OT  - Induced hyperthermia
OT  - Microwave ablation
OT  - Renal cancer
EDAT- 2017/04/20 06:00
MHDA- 2017/04/20 06:01
CRDT- 2017/04/20 06:00
PHST- 2016/12/11 [received]
PHST- 2017/04/04 [accepted]
AID - 10.1007/s12032-017-0948-8 [doi]
AID - 10.1007/s12032-017-0948-8 [pii]
PST - ppublish
SO  - Med Oncol. 2017 May;34(5):97. doi: 10.1007/s12032-017-0948-8. Epub 2017 Apr 19.

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