E2641. Long-Term Outcome After Thermal Ablation for Renal Cancer in the Non-Elderly, Healthy Population
Authors
Sanna Herwald;
Stanford University Medical Center
Wenhui Zhou;
Stanford University Medical Center
Raul Uppot;
Massachusetts General Hospital
Ronald Arellano;
Massachusetts General Hospital
Objective:
Treatment of renal cancer with thermal ablation has been largely limited to elderly, non-surgical candidates. The purpose of this study was to assess treatment outcomes and oncological survival following thermal ablation in the non-elderly, healthy population.
Materials and Methods:
Patients who were = 65 years of age and with an Eastern Cooperative Oncology Group (ECOG)/World Health Organization (WHO) performance status = 1 were retrospectively identified. A total of 65 patients underwent computed tomography-guided thermal ablation for 82 biopsy-proven T1N0M0 renal cell carcinoma between October 2008 and March 2020. Assessment of the rates of complication, residual disease, and local recurrence were performed to evaluate treatment outcomes. Cancer-specific survivals were computed using the Kaplan-Meier method.
Results:
A total of 82 non-elderly, healthy patients (median age = 55 years, SD = 11 years) were treated, with median Charlson comorbidity index scores of 2.2 (SD = 1.0). The mean tumor size was 2.2 cm (SD = 0.8 cm), and the mean RENAL nephrometry score was 5.8 (SD = 1.9). The most common histology findings were clear cell (67%) and papillary (22%) subtypes. Major complications were observed in two cases (3%), both of which were perinephric hematoma requiring blood transfusion (Clavien-Dindo Grade II). Primary technique efficacy was achieved in 98% of cases. At 3, 5 and 10 years after ablation, the cancer-specific survival rates were 98%, 95% and 93%, and local progression free survival rates were 98%, 92%, and 85% respectively.
Conclusion:
Renal ablation is a safe, effective, and durable treatment option for T1 renal cancers in non-elderly, otherwise healthy patients. Renal ablation could be considered an alternative treatment option for small renal tumors in young patients who might prefer to avoid surgery. This data incentivizes future investigations to directly compare the relative merits and risks of thermal ablation and surgical resection.
