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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Abstract
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 ...
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 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".