Bibliographic record
Abstract
Introduction and Objectives: Aim of this study was to assess safety and oncological outcomes of percutaneous radiofrequency ablation (PRFA) of renal cell carcinoma (RCC) in a prospective cohort of patients at high risk for surgery followed in a multidisciplinary environment. Methods: 36 consecutive patients with a solitary kidney (7), and/or prior ipsilateral partial nephrectomy and/or ASA score >3 underwent PRFA under CT guidance. Indication for treatment was solitary renal mass (<4 cm in size), multiple small masses and adrenal metastatic RCC in 29, 1 and 3 cases respectively. Prior to ablation, 3 percutaneous needle core biopsies were taken in all cases. Post-procedural CT scan was performed before discharge to exclude complications. All patients were followed with serial contrast-enhanced CT scans at 1,3,6 and 12 months. Endpoints of the study were safety, biopsy cancer detection rate, metastasis-free survival and OS. Results: We ablated 21 left-sided and 17 right-sided tumours, with mean size of 2.80.6 cm. On the immediate postoperative CT scan an asymptomatic subcapscular hematoma was seen in 8 patients that did not require treatment. Technical failure was seen in 2 patients successfully treated with repeat RFA. There were 3 Clavien II complications: a pneumothorax at puncture and 2 urine leaks treated with antegrade stenting. In 8 cases (24.2%), biopsy samples were insufficient for analysis, and Fuhrman grade could be scored in 8/27 (29.6%) cases. We identified clear cell RCC in 36 and papillary RCC in 2 cases. With median follow-up of 18 (4-30) months, 2 patients had evidence of residual disease and successfully underwent a second RFA. There was no mortality and no pt had developed metastases at follow-up. Conclusions: With meticulous patient selection, PRFA of RCC is a safe and effective treatment option for suboptimal candidates for renal surgery. Follow-up with serial CT scans is mandatory to identify persistent disease that can be treated with repeat PRFA.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".