Bibliographic record
Abstract
Introduction: Irreversible electroporation (Ire) is a novel, non-thermal ablation procedure used for treating small renal masses (smr), such as renal cell carcinomas (rcc).this prospective case series explores Ire's effectiveness and six-year outcomes in patients with difficult-to-treat rcc.We report tumor-free survival (tFs) and document complications and renal function changes.Methods: Ire was offered to patients with a biopsy-confirmed rcc in a solitary kidney, von Hippel lindau syndrome, or a difficult-to-treat rcc that was deemed amenable only to radical nephrectomy for tumor control.Followup protocol at three, 12, 24, 36, 48, 60, and 72 months post-Ire included creatinine, egFr, and gadolinium-enhanced mrI to monitor for residual or recurrent disease.Results: twenty-seven biopsy-proven rcc were treated in 27 patients.the median followup time was 42 months (range 3-72).post-Ire, six patients experienced immediate adverse events (ae): four transient hematuria (clavien-dindo grade [cd] 1), one hematoma requiring transfusion (cd 2), and one pe (cd 2).one patient received a ureteral stent for a delayed ureteral stricture (cd 3a). at three months, residual tumors were found in five patients, making a treatment success rate of 81.5%.Four patients were managed with salvage thermal ablation (three microwave [mWa], one radiofrequency) and one patient underwent laparoscopic nephrectomy (ln).Four patients with recurrent rcc (mean time of 21 months) were managed with surveillance, mWa, and ln.no patient developed metastasis.the six-year tFs rate was 79.3%, with no deaths due to rcc. the average egFr decline at 12 and 72 months was nine and 6.3 ml/min/1.73m2, respectively.Conclusions: this study demonstrates that patients with difficult-to-treat rccs can be treated with Ire safely and effectively.Immediate ae were limited to cd 2 and fully resolved.the procedure success rate and the six-year tFs rate suggest that Ire is a feasible option for patients with complex srm.larger and longer studies are needed to evaluate long-term oncologic and functional outcomes.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.725 | 0.487 |
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; the direct Gemma label and the distilled Codex classifier agree on what is shown here.
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".