ABLATE: a score to predict complications and recurrence rate in percutaneous treatments of renal lesions: Medical Oncology

Maurizio Papa, N. Suardi, A. Losa, G. Agostini, T. Maga, A.M. Ierardi, G. Carrafiello, F. Gaboardi, G. Cardone

Research output: Contribution to journalArticlepeer-review

Abstract

RENAL score has been validated on predicting adverse events and relapses in percutaneous treatments of renal lesions. To better fit interventional issues a modified score (mRENAL) has been introduced, but the only difference from the RENAL score is on the dimensional parameter. However, it remains of surgical derivation while a specific interventional score is missing. This study aims to obtain a specific score (ABLATE) to better quantify the risk of complications and relapses in percutaneous kidney ablation procedures compared to the existing surgical scores. Taking inspiration from previous papers, a score was built to quantify the real difficulties faced in percutaneous treatment of renal lesions. The ABLATE score was used on 71 cryoablations to evaluate its predictivity of complications and relapses. Logistic regression was used to predict complication incidence; Cox-regression was used for relapses; ROC analysis was used to evaluate the accuracy of the different scores. Between January 2014 and November 2019, 71 lesions in 68 patients were treated. Overall, malignant histology was found in 62 lesions (87.3%). Mean and median RENAL, mRENAL, and ABLATE scores were 7.04 and 7, 7.19 and 7, and 5.11 and 4, respectively. Out of 71 treatments, we experienced 3 bleeding with anemia (4.2%), only 2 of which needed further treatment (2.82%). The mean and median RENAL, mRENAL, and ABLATE scores in those with complications were 7.66 and 7.01 (p = 0.69), 8.0 and 7.1 (p = 0.54), and 6.6 and 5.0 (p = 0.38), respectively. Out of 62 malignant lesions, we experienced 2 persistent and 6 recurrent lesions (3.2% and 8.4%, respectively). At Cox-regression analyses, mABLATE score outperformed both RENAL and mRENAL scores in predicting recurrences (HR 1.48; p < 0.001 vs. 1.41; p = 0.1 vs. 1.38: p = 0.07, respectively). The ABLATE score showed to be a better predictor of relapses than RENAL and mRENAL. The small number of complications conditioned a lack of statistic power on complications for all the scores. At the moment to quantify the risks in percutaneous kidney ablation procedures, surgical scores are used. A specific score better performs this task. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
Original languageEnglish
Article number26
JournalMed. Oncol.
Volume37
Issue number4
DOIs
Publication statusPublished - 2020

Keywords

  • Ablate
  • Cryoablation
  • Interventional oncology
  • Kidney
  • Percutaneous ablation
  • Score
  • Tumor
  • ABLATE score
  • aged
  • anemia
  • Article
  • artificial embolization
  • controlled study
  • cryoablation
  • false aneurysm
  • female
  • follow up
  • histology
  • human
  • human tissue
  • iatrogenic disease
  • incidence
  • kidney artery embolization
  • kidney hemorrhage
  • kidney tumor
  • major clinical study
  • male
  • percutaneous biopsy
  • prediction
  • priority journal
  • recurrence free survival
  • recurrence risk
  • relapse
  • renal artery aneurysm
  • risk
  • scoring system
  • ablation therapy
  • adverse event
  • kidney disease
  • pathology
  • percutaneous nephrostomy
  • postoperative complication
  • predictive value
  • procedures
  • recurrent disease
  • treatment outcome
  • Ablation Techniques
  • Aged
  • Female
  • Humans
  • Kidney Diseases
  • Male
  • Nephrostomy, Percutaneous
  • Postoperative Complications
  • Predictive Value of Tests
  • Recurrence
  • Treatment Outcome

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