MP59-05 PERCUTANEOUS TUMOR ABLATION COMPARED TO PARTIAL NEPHRECTOMY FOR CT1A RENAL CANCER: THE IMPACT OF HISTOLOGIC VARIANT
Bibliographic record
Abstract
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 ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.017 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".