Presentation Authors: Mohamed Abdelsalam*, Tessa Hudspeth, Sharjeel Sabir, Samuel Kusin, Jose Karam, Surena Matin, Christopher Wood, Kamran Ahrar, Houston , TX
Introduction: To evaluate the local oncologic effectiveness of image guided thermal ablation of recurrent renal cell carcinoma (RCC) after ipsilateral partial nephrectomy
Methods: We reviewed our institutional database for patients who underwent renal ablation for local recurrence in the ipsilateral kidney following partial nephrectomy between January 2005 and December 2017. We described demographics, tumor size, procedure details, complications, pathology and local oncologic outcome on follow up imaging.
Results: Out of 525 renal ablations during the study period, a total of 33 patients (19 Males and 14 females) with a median age of 66 years met our inclusion criteria. Fifteen patients had a solitary kidney. Forty two procedures were performed for 46 lesions with average size of 2.3 cm (range 0.8-4.5 cm). Four lesions were at the surgical margin. Pathology report revealed negative tumor margin in 3 patients, the fourth patient had surgery at another institution with no pathology report available. Of the 42 procedures, 38 were performed under CT and 4 were performed under MRI guidance. Of the 46 lesions, 38 were treated with RFA and 8 were treated with cryoablation. Technical success was obtained in all cases. Adjunctive Techniques; hydrodissection and pyeloperfusion were performed in 11 and 2 cases respectively. Four patients (12 %) developed Clavien Grade III complications. Of the 37 biopsied lesions, 33 samples were diagnostic (20 clear cell and 13 papillary). Fuhrman grading was obtained in 27 lesions (Grade 1 = 2, Grade II = 21, Grade III = 4). Median follow up imaging was 4 years (0.9-11.5 years).Three lesions (6.5%) had residual/recurrence at the ablation site detected at 5.7, 6.6 and 7.3 months after ablation
Conclusions: Thermal ablation is effective in treatment of recurrent RCC after ipsilateral partial nephrectomy. Long term follow imaging reveals favorable oncologic outcome in those patients