MP59-05 PERCUTANEOUS TUMOR ABLATION COMPARED TO PARTIAL NEPHRECTOMY FOR CT1A RENAL CANCER: THE IMPACT OF HISTOLOGIC VARIANT
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You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy V (MP59)1 Sep 2021MP59-05 PERCUTANEOUS TUMOR ABLATION COMPARED TO PARTIAL NEPHRECTOMY FOR CT1A RENAL CANCER: THE IMPACT OF HISTOLOGIC VARIANT Lorenzo Bianchi, Francesco Chessa, Carlo Casablanca, Pietro Piazza, Angelo Mottaran, Matteo Droghetti, Carlo Roveroni, Eleonora Balestrazzi, Caterina Gaudiano, Alberta Cappelli, Francesco Modestino, Alessandro Bertaccini, Emanuela Marcelli, Angelo Porreca, Abano Terme, Bernardino De Concilio, Bassano del Grappa, Rita Golfieri, Carla Serra, Antonio Celia, Bassano del Grappa, Riccardo Schiavina, and Eugenio Brunocilla Lorenzo BianchiLorenzo Bianchi More articles by this author , Francesco ChessaFrancesco Chessa More articles by this author , Carlo CasablancaCarlo Casablanca More articles by this author , Pietro PiazzaPietro Piazza More articles by this author , Angelo MottaranAngelo Mottaran More articles by this author , Matteo DroghettiMatteo Droghetti More articles by this author , Carlo RoveroniCarlo Roveroni More articles by this author , Eleonora BalestrazziEleonora Balestrazzi More articles by this author , Caterina GaudianoCaterina Gaudiano More articles by this author , Alberta CappelliAlberta Cappelli More articles by this author , Francesco ModestinoFrancesco Modestino More articles by this author , Alessandro BertacciniAlessandro Bertaccini More articles by this author , Emanuela MarcelliEmanuela Marcelli More articles by this author , Angelo PorrecaAngelo Porreca More articles by this author , Abano TermeAbano Terme More articles by this author , Bernardino De ConcilioBernardino De Concilio More articles by this author , Bassano del GrappaBassano del Grappa More articles by this author , Rita GolfieriRita Golfieri More articles by this author , Carla SerraCarla Serra More articles by this author , Antonio CeliaAntonio Celia More articles by this author , Bassano del GrappaBassano del Grappa More articles by this author , Riccardo SchiavinaRiccardo Schiavina More articles by this author , and Eugenio BrunocillaEugenio Brunocilla More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002094.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The aim of the study is to compare oncologic outcomes of partial nephrectomy (PN), radiofrequency ablation (RFA) and cryoablation (Cryo) and to examine the potential benefit of ablative techniques compared to PN. METHODS: We retrospectively evaluated data from 665 (81.4%), 68 (8.3%) and 83 (10.3%) patients with cT1a renal cell carcinoma (RCC) who underwent laparoscopic or robotic PN, percutaneous RFA and Cryo at two tertiary centers, respectively. Younger patients were scheduled for PN. Ablative techniques were recommended in older patients at higher risk of complications. Kaplan-Meier curves depict recurrence-free survival (RFS) rates in the overall population and after stratifying according to tumor’s histology (namely, clear cell RCC and non-clear cell RCC) and size (namely<2 cm and 2-4 cm). Multivariable Cox regression model was used to identify predictors of recurrence. Cumulative-incidence plots evaluated disease recurrence and other causes of mortality (OCM). RESULTS: Patients referred to PN experienced higher rates of postoperative complications (30.7%) compared to men referred to RFA (10.3%) and Cryo (13.3%; p<0.001), with no significant difference for high grade complications (p=0.6). Patients referred to PN experienced higher RFS rate compared to those treated with RFA and Cryo at 60-month in the overall population (96.4% vs. 79.4 % and 87.8%), in patients with clear cell RCC (93.3% vs 75% and 80.4%) and in those with tumor of 2-4 cm (97.3% vs 78% and 84.4%; all p≤0.01). In patients with non-clear cell RCC and with tumor < 2 cm, PN showed higher RFS rate at 60-month as compared to RFA (97.9% vs 84.4% and 95.1% vs 78.1%, respectively; all p≤0.02). At multi-variate analysis, ablative techniques (RFA [HR=4.03] and Cryo [HR=3.86]) were independent predictors of recurrence (all p<0.03). At competing risks analysis, recurrence rate and OCM were 7.3% and 1.3% vs 25% and 7.2% vs 19.9% and 19.9% for PN, RFA and Cryo, respectively. CONCLUSIONS: PN and Cryo showed similar RFS rates in patients with non-clear cell RCC and with renal mass < 2 cm, therefore, biopsy of renal mass could be useful to select patients before renal ablation, to avoid to ablate tumors at higher risk of recurrence. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1031-e1031 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lorenzo Bianchi More articles by this author Francesco Chessa More articles by this author Carlo Casablanca More articles by this author Pietro Piazza More articles by this author Angelo Mottaran More articles by this author Matteo Droghetti More articles by this author Carlo Roveroni More articles by this author Eleonora Balestrazzi More articles by this author Caterina Gaudiano More articles by this author Alberta Cappelli More articles by this author Francesco Modestino More articles by this author Alessandro Bertaccini More articles by this author Emanuela Marcelli More articles by this author Angelo Porreca More articles by this author Abano Terme More articles by this author Bernardino De Concilio More articles by this author Bassano del Grappa More articles by this author Rita Golfieri More articles by this author Carla Serra More articles by this author Antonio Celia More articles by this author Bassano del Grappa More articles by this author Riccardo Schiavina More articles by this author Eugenio Brunocilla More articles by this author Expand All Advertisement Loading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,017 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».