E2960. Effect of Transarterial Embolization on Post-ablation Hematoma Volumes in Percutaneous Cryoablation of T1b or T2 Renal Cell Carcinoma
Authors
Matthew Raymond;
University of Alabama at Birmingham Hospital
Aliaksei Salei;
University of Alabama at Birmingham Hospital
Cody Savage;
University of Alabama at Birmingham Hospital
Junjian Huang;
University of Alabama at Birmingham Hospital
Theresa Caridi;
University of Alabama at Birmingham Hospital
Andrew Gunn;
University of Alabama at Birmingham Hospital
Objective:
To evaluate whether neoadjuvant transarterial embolization (TAE) of the primary mass prior to percutaneous cryoablation (CA) in patients with T1b or T2 renal cell carcinoma (RCC) reduces post-ablation hematoma volumes.
Materials and Methods:
Institutional medical records of the adult patients with T1b and T2a RCC treated between 2008 and 2021 were retrospectively reviewed and allocated to two groups: TAE+CA group, if CA was preceded by TAE; and CA group, if CA was performed alone. Demographic characteristics, comorbidity index, tumor size, tumor complexity, coagulation parameters, postprocedural complications, and volume of hematoma immediately after CA were collected.
Results:
12 patients (12 tumors) and 35 patients (36 tumors) were allocated to the TAE+CA and CA groups respectively. Mean age (73.1 ± 10.7 versus 66.3 ± 10.5, p = 0.06), sex (58.3% versus 61.1% male, p = 0.86), Charlson comorbidity index (7.6 ± 2.2 versus 6.6 ± 2.1, p = 0.2) and preprocedural international normalized ratio (1.13 ± 0.29 versus 1.1 ± 0.18, p = 0.69) were not significantly different between TAE+CA and CA groups. Tumor size and numeric RENAL score were significantly higher in TAE+CA group than in CA group (57.3 ± 11.9mm vs 46.7 ± 6.6mm, p = 0.0003, and 8.9 ± 1.2 versus 7.8 ± 1.5, p = 0.02, respectively). All TAE procedures were successful without complications. After CA procedure, no major hemorrhagic complications occurred in TAE+CA group while 3 occurred in CA group (0 versus 8.3%, p = 0.56) with mean post CA hematoma volume 47.1 ± 64.3 mL in TAE+CA group versus 117.19 ± 220.9 mL in CA group (p = 0.29).
Conclusion:
In this study, patients with T1b or T2 RCC treated with TAE prior to CA had no hemorrhagic complications after CA and had smaller volume hematomas; however, the latter did not reach statistical significance, despite having larger and more complex tumors.
