PD11-10 THE IMPACT OF HISTOLOGY AND TYPE OF ENERGY USED ON ONCOLOGICAL OUTCOMES AFTER LOCAL TUMOR ABLATION OF SMALL RENAL MASSES
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You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy I (PD11)1 May 2024PD11-10 THE IMPACT OF HISTOLOGY AND TYPE OF ENERGY USED ON ONCOLOGICAL OUTCOMES AFTER LOCAL TUMOR ABLATION OF SMALL RENAL MASSES Pietro Piazza, Lorenzo Bianchi, Stefano Luzzago, Marco Bandini, Angelo Mottaran, Sasan Amirhassankhani, Bernardino De Concilio, Antonio Celia, Stefano Puliatti, Riccardo Scarlatti, Carla Serra, Alberta Cappelli, Rita Golfieri, Gennaro Musi, Andrea Gallina, Riccardo Schiavina, Ottavio De Cobelli, Francesco Montorsi, and Eugenio Brunocilla Pietro PiazzaPietro Piazza , Lorenzo BianchiLorenzo Bianchi , Stefano LuzzagoStefano Luzzago , Marco BandiniMarco Bandini , Angelo MottaranAngelo Mottaran , Sasan AmirhassankhaniSasan Amirhassankhani , Bernardino De ConcilioBernardino De Concilio , Antonio CeliaAntonio Celia , Stefano PuliattiStefano Puliatti , Riccardo ScarlattiRiccardo Scarlatti , Carla SerraCarla Serra , Alberta CappelliAlberta Cappelli , Rita GolfieriRita Golfieri , Gennaro MusiGennaro Musi , Andrea GallinaAndrea Gallina , Riccardo SchiavinaRiccardo Schiavina , Ottavio De CobelliOttavio De Cobelli , Francesco MontorsiFrancesco Montorsi , and Eugenio BrunocillaEugenio Brunocilla View All Author Informationhttps://doi.org/10.1097/01.JU.0001008604.95535.b9.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To evaluate the impact of the histology at pre-procedure biopsy and the type of energy used for local tumor ablation (LTA, including Radiofrequency ablation [RFA], Cryoablation [Cryo], Microwave ablation [MW]) on long-term oncologic outcomes in patients with cT1a renal masses. METHODS: We retrospectively evaluated 650 patients treated with LTA for cT1a renal tumors at 4 European tertiary centers; excluding patient lost the final population was 574 patients. Individuals with cT1a renal mass unfit for surgery were primary scheduled for LTA in each center. Patients were treated with percutaneous RFA, Cryo or MW according to the technique available in each center. Outcome of interest were followings: recurrence free survival (R-FS) and cancer specific mortality-free survival (CSM-FS) in patients with malign histology. Kaplan-Meier curves were used to investigate 5-years RFS and CSM-FS according to the histology at biopsy and the technique used for ablation. Multivariable Cox's proportional hazard regressions were performed to identify predictors of R-FS. RESULTS: Overall, 197 (34%), 241 (42%) and 136 (24%) patients were treated with RFA, Cryo and MW, respectively. Overall, 350 (60%) patients had ASA score ≥3. Median tumor size was 2.2 (IQR 1.7-3) cm. At biopsy, 330 (57%), 86 (15%), 9 (1,6%), 87 (15%), 9 (1.6%), 6 (1%) and 47 (8.2%) tumors were clear cell carcinoma, papillary, chromophobe, oncocytoma, angiomyolipoma, mixed tumors and non-diagnostic, respectively. All the procedures were complete, with no sign of residual tumor at the 24 hours imaging. During a median follow-up of 60 months (IQR 35-87), 67 (12%) patients experienced local recurrence, while 20 patients (3.5%) experienced systemic recurrence. The 5-years R-FS was 65%, 88% and 82% (p<0.001) and the 5-years CSM-FS was 96%, 94% and 98% (p=0.8) for patients treated with RFA, Cryo and MW, respectively; according to the histology, the 5-years R-FS was 73%, 89%, 74%, 62%, 96% (p=0.003) and the 5-ys CSM-FS was 94%, 100%, 100%, 100%, 100% (p=0.19) for clear cell carcinoma, papillary, chromophobe, mixed tumors and non-diagnostic histology, respectively. At multivariable analysis, clinical size (HR 1.51, CI 1.17-1.95, p=0.001), papillary histology (HR 0.27, CI 0.09-0.64, p=0.007) and MW ablation (HR 0.45, CI 0.22-0.88, p=0.02) were independent predictors of RFS. CONCLUSIONS: Percutaneous LTA is a safe and effective approach to small renal masses in patients unfit for surgery. MW ablation, smaller clinical size and papillary histology are associated with lower risk of 5-year recurrence. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e254 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Pietro Piazza More articles by this author Lorenzo Bianchi More articles by this author Stefano Luzzago More articles by this author Marco Bandini More articles by this author Angelo Mottaran More articles by this author Sasan Amirhassankhani More articles by this author Bernardino De Concilio More articles by this author Antonio Celia More articles by this author Stefano Puliatti More articles by this author Riccardo Scarlatti More articles by this author Carla Serra More articles by this author Alberta Cappelli More articles by this author Rita Golfieri More articles by this author Gennaro Musi More articles by this author Andrea Gallina More articles by this author Riccardo Schiavina More articles by this author Ottavio De Cobelli More articles by this author Francesco Montorsi More articles by this author Eugenio Brunocilla More articles by this author Expand All Advertisement PDF downloadLoading ...
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 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 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 ».