Treatment Failure After Image-Guided Percutaneous Radiofrequency Ablation (RFA) of Renal Tumors – A Systematic Review with Description of Type, Frequency, Risk Factors and Management

Vollherbst, Dominik F; Bertheau, Robert C.; Kauczor, Hans‐Ulrich; Radeleff, Boris; Pereira, Philippe L.; Sommer, CM

doi:10.1055/s-0042-115817

Cited by 4 publications

(7 citation statements)

References 18 publications

(24 reference statements)

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“…Our complication rate of 5.5% is within the range of the 5.1–37% reported by the Vollherbst et al Systematic review [24]. RNS and tumor diameter were larger in the cases with complications, however no significant difference was found.…”

Section: Discussionsupporting

confidence: 79%

“…We observed a 6.7% tumor persistence rate, which is slightly higher than the 5.9% reported in the systematic review performed by Vollherbst et al [24] but lower than the 13% reported by Ptsuka et al [25]. We observed that tumor median size was significantly higher in patients with persistence.…”

Section: Discussioncontrasting

confidence: 67%

“…We found a recurrence rate of 9.2% (10.5% in biopsy proven cases) which is on the higher end of the interval observed in literature according to the Vollherbst et al systematic review [24]. Tumor size was significantly higher in patients with recurrence.…”

Section: Discussionsupporting

confidence: 45%

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Association among the R.E.N.A.L. nephrometry score and clinical outcomes in patients with small renal masses treated with percutaneous contrast enhanced ultrasound radiofrequency ablation

Konstantinidis

Trilla

Serres

et al. 2019

Cent european J Urol

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Introduction An association between the R.E.N.A.L. nephrometry score (RNS) and clinical outcomes in patients with a small renal mass (SRM) has been proposed. We analyzed clinical outcomes according to the RNS in patients with a SRM treated with percutaneous contrast enhanced ultrasound (CEUS) radiofrequency ablation (RFA). Material and methods Patients with a SRM, who underwent RFA between January 2005 and March 2015, were retrospectively identified. The association between RNS and clinical outcomes was evaluated using parametric and non-parametric analysis. Results We analyzed 163 SRMs in 149 consecutive patients. The mean age was 71.7 years. Mean follow-up time was 33.3 months ±20.6 (2–102). The mean RNS was 5.6 ±1.52 (4–11). A total of 121 (74.2%) cases were of low complexity and 42 (25.8%) were medium complexity. We identified 11 cases of tumor persistence (6.7%). The mean RNS was 5.58 in the cases with no persistence and 5.73 in the cases with persistence (p = 0.788). We identified 15 (9.2%) cases of recurrence. The mean RNS was 5.57 ±0.1 (4–11) in the cases without recurrence and 5.73 ±0.4 (4–9) in recurrence cases (p = 0.804). Of the 76 biopsy proven RCC cases, 8 (10.5%) cases of recurrence were observed, 5 in the low complexity group and 3 in the medium complexity group (p = 0.690). A total of 9 (5.5%) cases of complications were observed, with 5 (4.3%) in the low complexity group and 4 cases in the medium complexity group (p = 0.23). The mean length of stay was 1.5 days with a significant difference between low and medium complexity groups (1.3 vs. 2.1 days, p = 0.02). The mean difference between preoperative eGFR and estimated eGFRat 12 months was -3.08 mL / min ±13.3 (-49.4–34.1) and was significant (p = 0.008).However, this variation did not show significant differences between the low and medium complexity groups (p = 0.936). All-cause mortality was 11.7%, 14 cases (11.6%) in the low complexity group and 5 (11.9%) in the medium complexity group (p = 1.0). No cases of renal cell carcinoma (RCC) specific mortality were identified. Conclusions The RNS was not associated with tumor persistence, recurrence, cancer specific mortality, complications or renal function 12 months after the first treatment, showing significant difference only in length of hospital stay between low and medium complexity groups.

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Section: Discussionsupporting

confidence: 79%

Section: Discussioncontrasting

confidence: 67%

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Association among the R.E.N.A.L. nephrometry score and clinical outcomes in patients with small renal masses treated with percutaneous contrast enhanced ultrasound radiofrequency ablation

Konstantinidis

Trilla

Serres

et al. 2019

Cent european J Urol

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“…The adverse events of ethiodized oil tumor marking and IRE were collected and classified under the updated standards of the Society of Interventional Radiology [ 30 ]. For the radiological follow-up, two major endpoints for local treated HCCs were defined based on LI-RADS 2018: endpoint-1—residual unablated tumor that was defined in the initial follow-up imaging demonstrated to be residual HCC at the ablative margin (LR-TR), endpoint-2—local tumor progression that was defined after at least one contrast-enhanced radiological follow-up study documenting an absence of viable tumor tissue in/around the target-HCC, new HCC foci appeared at the edge of the IRE zone (LR-TR) in further follow-up [ 21 , 25 , 31 ]. Both endpoint-1 and endpoint-2 were defined as treatment failures [ 31 ].…”

Section: Methodsmentioning

confidence: 99%

“…For the radiological follow-up, two major endpoints for local treated HCCs were defined based on LI-RADS 2018: endpoint-1—residual unablated tumor that was defined in the initial follow-up imaging demonstrated to be residual HCC at the ablative margin (LR-TR), endpoint-2—local tumor progression that was defined after at least one contrast-enhanced radiological follow-up study documenting an absence of viable tumor tissue in/around the target-HCC, new HCC foci appeared at the edge of the IRE zone (LR-TR) in further follow-up [ 21 , 25 , 31 ]. Both endpoint-1 and endpoint-2 were defined as treatment failures [ 31 ]. A radiological interpretation of the endpoints was performed by two radiologists together (with more than ten and eight years of experience, respectively, in abdominal radiology).…”

Section: Methodsmentioning

confidence: 99%

Percutaneous Irreversible Electroporation for Treatment of Small Hepatocellular Carcinoma Invisible on Unenhanced CT: A Novel Combined Strategy with Prior Transarterial Tumor Marking

Pan

Duong

Vollherbst

et al. 2021

Cancers

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Introduction. To explore the feasibility, safety, and efficiency of ethiodized oil tumor marking combined with irreversible electroporation (IRE) for small hepatocellular carcinomas (HCCs) that were invisible on unenhanced computed tomography (CT). Methods. A retrospective analysis of the institutional database was performed from January 2018 to September 2018. Patients undergoing ethiodized oil tumor marking to improve target-HCC visualization in subsequent CT-guided IRE were retrieved. Target-HCC visualization after marking was assessed, and the signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNR) were compared between pre-marking and post-marking CT images using the paired t-test. Standard IRE reports, adverse events, therapeutic endpoints, and survival were summarized and assessed. Results. Nine patients with 11 target-HCCs (11.1–18.8 mm) were included. After marking, all target-HCCs demonstrated complete visualization in post-marking CT, which were invisible in pre-marking CT. Quantitatively, the SNR of the target-HCCs significantly increased after marking (11.07 ± 4.23 vs. 3.36 ± 1.79, p = 0.006), as did the CNR (4.32 ± 3.31 vs. 0.43 ± 0.28, p = 0.023). In sequential IRE procedures, the average current was 30.1 ± 5.3 A, and both the delta ampere and percentage were positive with the mean values of 5.8 ± 2.1 A and 23.8 ± 6.3%, respectively. All procedures were technically successful without any adverse events. In the follow-up, no residual unablated tumor (endpoint-1) was observed. The half-year, one-year, and two-year local tumor progression (endpoint-2) rate was 0%, 9.1%, and 27.3%. The two-year overall survival rate was 100%. Conclusions. Ethiodized oil tumor marking enables to demarcate small HCCs that were invisible on unenhanced CT. It potentially allows a safe and complete ablation in subsequent CT-guided IRE.

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Radiofrequenz- und Mikrowellenablation

Lindauer

Pereira

2022

Springer Reference Medizin

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Treatment Failure After Image-Guided Percutaneous Radiofrequency Ablation (RFA) of Renal Tumors – A Systematic Review with Description of Type, Frequency, Risk Factors and Management

Cited by 4 publications

References 18 publications

Association among the R.E.N.A.L. nephrometry score and clinical outcomes in patients with small renal masses treated with percutaneous contrast enhanced ultrasound radiofrequency ablation

Association among the R.E.N.A.L. nephrometry score and clinical outcomes in patients with small renal masses treated with percutaneous contrast enhanced ultrasound radiofrequency ablation

Percutaneous Irreversible Electroporation for Treatment of Small Hepatocellular Carcinoma Invisible on Unenhanced CT: A Novel Combined Strategy with Prior Transarterial Tumor Marking

Radiofrequenz- und Mikrowellenablation

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