Alexander J King, Retha Steenkamp, Ole Graumann, Tze Min Wah, Des Alcorn, Tommy Kjaergaard Nielsen, Eric de Kerviler, Patricia J Zondervan, Miles Walkden, Brunolf Lagerveld, Marco Van Strijen, Francis X Keeley, David J Breen
{"title":"Risk Factors for Residual Unablated Tumour Following CT-Guided Percutaneous Renal Cryoablation: Lessons from the EuRECA Registry.","authors":"Alexander J King, Retha Steenkamp, Ole Graumann, Tze Min Wah, Des Alcorn, Tommy Kjaergaard Nielsen, Eric de Kerviler, Patricia J Zondervan, Miles Walkden, Brunolf Lagerveld, Marco Van Strijen, Francis X Keeley, David J Breen","doi":"10.1007/s00270-024-03951-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To assess tumour factors that reduce primary technical efficacy (PTE) from CT-guided renal cryoablation.</p><p><strong>Methods: </strong>Patients were taken from the EuRECA registry between December 2014 and November 2020. To focus on tumour factors rather than individual technique, this study was limited to cases using CT and excluded procedures using cone beam, US, MRI, or laparoscopy. PTE was assessed per tumour and defined as complete ablation of the target on enhanced CT or MRI by 90 days. Residual unablated tumour (RUT) was defined as focal persistent tumour enhancement within 90 days.</p><p><strong>Results: </strong>A total of 1,424 tumours from 11 different centres were eligible; 38 episodes of RUT were detected giving an overall PTE of 97.3%. The factors most likely to be associated with RUT were as follows and persisted in multivariate logistic regression. Tumour contact with a central artery or vein; increased OR of 5.29 (CI 2.59-10.81 p < 0.001), PTE was 89.8% in this group. Tumours size; T1b vs T1a increased OR of 2.31 (CI 1.10-4.87 p = 0.0276), T1b PTE was 94.1% vs T1a PTE 97.9%. Close proximity to the collecting system (< 4 mm) was significant at univariate logistic regression (OR 2.87, P = 0.028), as was a RENAL complexity score of 10 or above (OR 2.71, p = 0.0147), but neither was significant in the multivariate analysis.</p><p><strong>Conclusions: </strong>Overall, CT-guided percutaneous renal cryoablation has a high PTE at 97.3%. In this analysis, the most significant risk factor for RUT is central renal vessel contact. T1b tumours are also noted to have an increased risk of RUT compared to T1a.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"196-204"},"PeriodicalIF":2.8000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"CardioVascular and Interventional Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00270-024-03951-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/16 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To assess tumour factors that reduce primary technical efficacy (PTE) from CT-guided renal cryoablation.
Methods: Patients were taken from the EuRECA registry between December 2014 and November 2020. To focus on tumour factors rather than individual technique, this study was limited to cases using CT and excluded procedures using cone beam, US, MRI, or laparoscopy. PTE was assessed per tumour and defined as complete ablation of the target on enhanced CT or MRI by 90 days. Residual unablated tumour (RUT) was defined as focal persistent tumour enhancement within 90 days.
Results: A total of 1,424 tumours from 11 different centres were eligible; 38 episodes of RUT were detected giving an overall PTE of 97.3%. The factors most likely to be associated with RUT were as follows and persisted in multivariate logistic regression. Tumour contact with a central artery or vein; increased OR of 5.29 (CI 2.59-10.81 p < 0.001), PTE was 89.8% in this group. Tumours size; T1b vs T1a increased OR of 2.31 (CI 1.10-4.87 p = 0.0276), T1b PTE was 94.1% vs T1a PTE 97.9%. Close proximity to the collecting system (< 4 mm) was significant at univariate logistic regression (OR 2.87, P = 0.028), as was a RENAL complexity score of 10 or above (OR 2.71, p = 0.0147), but neither was significant in the multivariate analysis.
Conclusions: Overall, CT-guided percutaneous renal cryoablation has a high PTE at 97.3%. In this analysis, the most significant risk factor for RUT is central renal vessel contact. T1b tumours are also noted to have an increased risk of RUT compared to T1a.
期刊介绍：
CardioVascular and Interventional Radiology (CVIR) is the official journal of the Cardiovascular and Interventional Radiological Society of Europe, and is also the official organ of a number of additional distinguished national and international interventional radiological societies. CVIR publishes double blinded peer-reviewed original research work including clinical and laboratory investigations, technical notes, case reports, works in progress, and letters to the editor, as well as review articles, pictorial essays, editorials, and special invited submissions in the field of vascular and interventional radiology. Beside the communication of the latest research results in this field, it is also the aim of CVIR to support continuous medical education. Articles that are accepted for publication are done so with the understanding that they, or their substantive contents, have not been and will not be submitted to any other publication.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
