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Inicio Radiología (English Edition) Percutaneous ablation of renal tumors: Long-term outcomes
Journal Information
Vol. 65. Issue 6.
Pages 492-501 (November - December 2023)
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Vol. 65. Issue 6.
Pages 492-501 (November - December 2023)
Original articles
Percutaneous ablation of renal tumors: Long-term outcomes
Ablación percutánea de tumores renales: resultados a largo plazo
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J.L. del Cura Rodrígueza,
Corresponding author
, R. Zabala-Landab, I. Korta-Gomezb
a Servicio de Radiodiagnóstico, Hospital Universitario Donostia, Donostia-San Sebastián, Spain
b Servicio de Radiodiagnóstico, Hospital Universitario Basurto, Bilbao, Vizcaya, Spain
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Figures (2)
Tables (6)
Table 1. Results of lesion biopsies.
Table 2. Lesion characteristics.
Table 3. Complications.
Table 4. Association of multiple variables with the occurrence of complications.
Table 5. Incomplete and recurrent treatments (n = 299).
Table 6. Association of multiple variables with incomplete ablation or late recurrence.
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Abstract
Objective

To evaluate the long-term outcomes of renal tumor ablation, analyzing efficacy, long-term survival, and factors associated with complications and therapeutic success.

Material and methods

We retrospectively reviewed 305 ablations (generally done with expandable electrodes) of 273 renal tumors between May 2005 and April 2019. We analyzed survival, primary and secondary efficacy, and complications according to various patient factors and tumor characteristics.

Results

Mean blood creatinine was 1.14 mg/dL before treatment and 1.30 mg/dL after treatment (p < 0.0001). Complications were observed in 13.25% of the ablations, including major complications in in 4.97%. Complications were associated with age (p = 0.013) and tumor diameter (p < 0.0001). Primary efficacy was 96.28%. Incomplete ablation was more common in lesions measuring > 4 cm in diameter (p = 0.002). Secondary efficacy was 95.28%. The only factor associated with the risk of recurrence was the size of the tumor (p = 0.02). Overall survival was 95.26% at 1 year, 77.01% at 5 years, and 51.78% at 10 years, with no differences between patients with malignant and benign lesions. Mortality was higher in patients with creatinine >1 (p = 0.05) or ASA > 2 (p = 0.0001).

Conclusions

Percutaneous ablation is extremely efficacious for renal tumors; it improves the prognosis of renal carcinoma to the point where it does not differ from that of benign lesions. Complications are rare. Like survival, complications are associated with age and overall health status.

Palabras clave:
Riñón
Neoplasia renal
Técnicas de ablación
Biopsia con aguja
Supervivencia
Resumen
Objetivo

Valorar resultados a largo plazo de la ablación de tumores renales analizando eficacia, supervivencia a largo plazo y factores asociados con complicaciones y éxito terapéutico.

Material y métodos

Revisión retrospectiva de 305 ablaciones, en general usando radiofrecuencia con electrodos desplegables, sobre 273 lesiones de tumores renales entre mayo de 2005 y abril de 2019. Se analizó supervivencia, eficacia primaria y secundaria y complicaciones relacionándolas con diversos factores del paciente y características de los tumores tratados.

Resultados

La creatinina en sangre media previa al tratamiento fue de 1,14 mg/dL y al año de 1,30 mg/dL (p < 0,0001). Hubo complicaciones en el 13,25% de las ablaciones (mayores, 4,97%) que se relacionaron con edad (p = 0,013) y diámetro tumoral (p < 0,0001). La eficacia primaria fue del 96,28%. Las lesiones de más de 4 cm fueron más propensas a presentar ablaciones incompletas (p = 0,002). La eficacia secundaria: fue del 95,28%. El riesgo de recurrencia se relacionó solo con el tamaño del tumor (p = 0,02). La supervivencia global fue del 95,26% al año, 77,01% a los 5 años y 51,78% a los 10 años. No se observaron diferencias en función de la naturaleza maligna o benigna de la lesión tratada. La mortalidad aumentaba en pacientes con creatinina superior a 1 (p = 0,05) o ASA > 2 (p = 0,0001).

Conclusiones

La ablación percutánea de tumores renales es una técnica de altísima eficacia, que permite igualar el pronóstico de un carcinoma renal, tras el tratamiento, al de una lesión benigna. Las complicaciones son muy infrecuentes y se relacionan, al igual que la supervivencia, con edad y estado de salud del paciente.

Keywords:
Kidney
Renal tumor
Ablation techniques
Needle biopsy
Survival

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