TY - JOUR
T1 - R.E.N.A.L. (Radius, Exophytic/Endophytic, Nearness to Collecting System or Sinus, Anterior/Posterior, and Location Relative to Polar Lines) nephrometry score predicts early tumor recurrence and complications after percutaneous ablative therapies for renal cell carcinoma
T2 - A 5-year experience
AU - Camacho, Juan C.
AU - Kokabi, Nima
AU - Xing, Minzhi
AU - Master, Viraj A.
AU - Pattaras, John G.
AU - Mittal, Pardeep K.
AU - Kim, Hyun S.
N1 - Publisher Copyright:
© 2015 SIR.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Purpose To investigate the prognostic value of R.E.N.A.L. (radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, and location relative to polar lines) nephrometry score after percutaneous ablation of renal cell carcinoma (RCC). Materials and Methods A retrospective 5-year study was performed. Participants were 87 consecutive patients (median age, 67.1 y; 59.7% male, 40.3% female) with 101 biopsy-proven RCCs who underwent percutaneous ablation (54.0% cryoablation, 46.0% radiofrequency ablation). Follow-up computed tomography or magnetic resonance imaging was performed in all cases (mean follow-up, 34.6 mo ± 23.5). R.E.N.A.L. scores were analyzed to determine the association of the score with treatment outcomes and complications. Results All tumors corresponded to stage 1A disease. Mean tumor size was 2.05 cm (range, 0.7-3.9 cm), and 50.5% of the lesions measured > 2 cm. Nephrometry score was > 8 in 31.4% of lesions. Overall recurrence rate was 16.8%, first-year recurrence rate was 7.9%, and complication rate was 9.9%. A nephrometry score > 8 was associated with increased complications after percutaneous ablation (P <.0001), increased overall recurrence (P <.0001), and increased risk of first-year recurrence (P <.0001). Immediate complications were associated with tumor size > 2 cm (P <.0001) and risk of local recurrence (P <.001). Age, gender, and percutaneous ablation technique were not correlated with recurrence or immediate complications. Patients undergoing cryoablation had a higher nephrometry score with no significant differences in recurrence rate compared with RF ablation (P =.199). Conclusions A R.E.N.A.L. nephrometry score ≥ 8 predicts recurrence and complications after percutaneous renal ablation.
AB - Purpose To investigate the prognostic value of R.E.N.A.L. (radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, and location relative to polar lines) nephrometry score after percutaneous ablation of renal cell carcinoma (RCC). Materials and Methods A retrospective 5-year study was performed. Participants were 87 consecutive patients (median age, 67.1 y; 59.7% male, 40.3% female) with 101 biopsy-proven RCCs who underwent percutaneous ablation (54.0% cryoablation, 46.0% radiofrequency ablation). Follow-up computed tomography or magnetic resonance imaging was performed in all cases (mean follow-up, 34.6 mo ± 23.5). R.E.N.A.L. scores were analyzed to determine the association of the score with treatment outcomes and complications. Results All tumors corresponded to stage 1A disease. Mean tumor size was 2.05 cm (range, 0.7-3.9 cm), and 50.5% of the lesions measured > 2 cm. Nephrometry score was > 8 in 31.4% of lesions. Overall recurrence rate was 16.8%, first-year recurrence rate was 7.9%, and complication rate was 9.9%. A nephrometry score > 8 was associated with increased complications after percutaneous ablation (P <.0001), increased overall recurrence (P <.0001), and increased risk of first-year recurrence (P <.0001). Immediate complications were associated with tumor size > 2 cm (P <.0001) and risk of local recurrence (P <.001). Age, gender, and percutaneous ablation technique were not correlated with recurrence or immediate complications. Patients undergoing cryoablation had a higher nephrometry score with no significant differences in recurrence rate compared with RF ablation (P =.199). Conclusions A R.E.N.A.L. nephrometry score ≥ 8 predicts recurrence and complications after percutaneous renal ablation.
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U2 - 10.1016/j.jvir.2015.01.008
DO - 10.1016/j.jvir.2015.01.008
M3 - Article
C2 - 25769213
AN - SCOPUS:84928827682
SN - 1051-0443
VL - 26
SP - 686
EP - 693
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 5
ER -