E2960. Effect of Transarterial Embolization on Post-ablation Hematoma Volumes in Percutaneous Cryoablation of T1b or T2 Renal Cell Carcinoma
  1. Matthew Raymond; University of Alabama at Birmingham Hospital
  2. Aliaksei Salei; University of Alabama at Birmingham Hospital
  3. Cody Savage; University of Alabama at Birmingham Hospital
  4. Junjian Huang; University of Alabama at Birmingham Hospital
  5. Theresa Caridi; University of Alabama at Birmingham Hospital
  6. Andrew Gunn; University of Alabama at Birmingham Hospital
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.

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).

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.