Irreversible electroporation of small renal masses: suboptimal oncologic efficacy in an early series

Canvasser, Noah; Sorokin, Igor; Lay, Aaron; Morgan, Monica; Özayar, Asım; Trimmer, Clayton; Cadeddu, Jeffrey A.

doi:10.1007/s00345-017-2025-5

Cited by 30 publications

(20 citation statements)

References 30 publications

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“…The success rate of the procedure was 100%. The mean tumor size was 2.3 cm±1.1 cm (range: 1.1-4.5 cm), with an average score of 6.5 (range [4][5][6][7][8][9] per R.E.N.A.L. criteria (radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, and location relative to polar lines).…”

Section: Resultsmentioning

confidence: 99%

“…Compared with the decrease in renal function after thermal ablation for RCC [8] , no signi cant changes in renal function or serious complications of IRE treatment for RCC have been reported in the literature. Noah E. Canvasser et al [9] chose 42 cT1a RCC lesions from 41 patients with IRE. The initial treatment success rate was 93% (39/42), and the 2-year local-recurrence-free survival (LRFS) was 83%.…”

Section: Discussionmentioning

confidence: 99%

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A Retrospective Study of CT-Guided Percutaneous Irreversible Electroporation (IRE) Ablation: Clinical Efficacy and Safety

Wang

Lü

Wei

et al. 2020

Preprint

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BackgroundTo evaluate the clinical efficacy and safety of ablating renal cell carcinoma (RCC) by irreversible electroporation (IRE). MethodsFifteen patients (19 lesions) with RCC who underwent IRE were retrospectively reviewed. Seven patients had solitary kidneys. Two lesions were located in the renal hilus. One patient had chronic renal insufficiency. Percutaneous biopsy for histopathology was performed. The best puncture path plan was evaluated before CT-guided IRE. The estimated glomerular filtration rate (eGFR) was compared vs baseline at 1-2 months after the ablation. Contrast-enhanced computed tomography imaging changes were evaluated immediately after IRE. Contrast-enhanced computed tomography/magnetic resonance was performed 1 month, 3 months, 6 months, 12 months and every year thereafter. The complications after treatment were also reviewed. ResultsThe success rate of the procedure was 100%. The mean tumor size was 2.3 cm±1.1 cm (range: 1.1-4.5 cm), with an average score of 6.5 (range 4-9) per R.E.N.A.L. criteria (radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, and location relative to polar lines). Two cases (3 lesions) were punctured through the liver. In other cases, puncture was performed through the perirenal space. There were no severe complications in interventional therapy. Transient gross hematuria occurred in 2 patients (centrally located). Self-limiting perinephric hematomas occurred in 1 patient. Needle puncture path metastasis was found in 1 patient 2.5 years after IRE. The subcutaneous metastasis was surgically removed, and there was no evidence of recurrence. There was no significant change in eGFR levels in terms of short- term clinical outcomes (t=0.348, P=0.733). At 6 months, all 15 patients with imaging studies available had no evidence of recurrence. At 1 year, 1 patient (1 of 15) was noted to have experienced needle tract metastasis and accepted salvage radiofrequency ablation (RFA) therapy. ConclusionsIRE appears to be a safe and effective treatment for RCC that may offer a tissue-sparing method and complete ablation as an alternative therapy for RCC.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Retrospective Study of CT-Guided Percutaneous Irreversible Electroporation (IRE) Ablation: Clinical Efficacy and Safety

Wang

Lü

Wei

et al. 2020

Preprint

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“…Wendler et al have done extensive work on IRE in the IRENE study, in which patients underwent percutaneous CT-guided IRE and 4 weeks later radical or partial nephrectomy [23–25]. Canvasser et al published about 42 renal tumors for which CT-guided IRE was performed [26]. Buijs et al submitted a paper presenting the preliminary results of ten patients who underwent percutaneous IRE [27].…”

Section: Irreversible Electroporation (Ire)mentioning

confidence: 99%

“…A high percentage of residual disease was reported (range 7–37.5%). Some of the authors suggested that residual tumor was most likely the result of probe malpositioning [21, 26, 27]. Wendler et al have done extensive work on IRE in the IRENE study in which patients underwent percutaneous CT-guided IRE and 4 weeks later radical or partial nephrectomy.…”

Section: Irreversible Electroporation (Ire)mentioning

confidence: 99%

Available ablation energies to treat cT1 renal cell cancer: emerging technologies

et al. 2018

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PurposeAn increasing interest in percutaneous ablation of renal tumors has been caused by the increasing incidence of SRMs, the trend toward minimally invasive nephron-sparing treatments and the rapid development of local ablative technologies. In the era of shared decision making, patient preference for non-invasive treatments also leads to an increasing demand for image-guided ablation. Although some guidelines still reserve ablation for poor surgical candidates, indications may soon expand as evidence for the use of the two most validated local ablative techniques, cryoablation (CA) and radiofrequency ablation (RFA), is accumulating. Due to the collaboration between experts in the field in biomedical engineering, urologists, interventional radiologists and radiation oncologists, the improvements in ablation technologies have been evolving rapidly in the last decades, resulting in some new emerging types of ablations.MethodsA literature search was conducted to identify original research articles investigating the clinical outcomes of new emerging technologies, percutaneous MWA, percutaneous IRE and SABR, in patients with primary cT1 localized renal cell cancer.ResultsDue to the collaboration between experts in the field in biomedical engineering, urologists, interventional radiologists and radiation oncologists, the improvements in ablation technologies have been evolving rapidly in the last decades. New emerging technologies such as microwave ablation (MWA), irreversible electroporation (IRE) and stereotactic ablative radiotherapy (SABR) seem to be getting ready for prime time.ConclusionThis topical paper describes the new emerging technologies for cT1 localized renal cell cancer and investigates how they compare to CA and RFA.

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“…A recent study on the use of irreversible electroporation in 42 SRM indicated that at 3-year oncological outcomes may be unfavourable compared to other techniques [66]. Similarly, the treatment efficacy of both percutaneous and laparoscopic HIFU and the safety of the former in the treatment renal lesions have been questioned [67,68].…”

Section: B Energy Sourcesmentioning

confidence: 99%

Surgical and Minimally Invasive Therapies for the Management of the Small Renal Mass

2017

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This article aims to summarise recent developments in surgical and minimally invasive therapies in the management of small renal masses (SRM). Recent FindingsThe incidence of the small renal mass is increasing. Standard management of the SRM is partial nephrectomy. More recently, use of ablative techniques to manage the SRM has been increasing and an exciting array of technical advances are currently being made in the field.Nephron-sparing surgery looks set to become more financially viable with the advent of newer robotic platforms and, potentially even less invasive with the evaluation of single-port access. Real-time imaging promises to improve tumour definition, nephron preservation and vascular management intraoperatively. SummaryAdvances in surgical and minimally invasive therapies for the management of the SRM have the potential to improve cancer clearance and long-term renal function preservation. Patients will experience safer, more reliable and less invasive treatments for their small renal tumours. We describe the current advances underlying these changes.

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Irreversible electroporation of small renal masses: suboptimal oncologic efficacy in an early series

Cited by 30 publications

References 30 publications

A Retrospective Study of CT-Guided Percutaneous Irreversible Electroporation (IRE) Ablation: Clinical Efficacy and Safety

A Retrospective Study of CT-Guided Percutaneous Irreversible Electroporation (IRE) Ablation: Clinical Efficacy and Safety

Available ablation energies to treat cT1 renal cell cancer: emerging technologies

Surgical and Minimally Invasive Therapies for the Management of the Small Renal Mass

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