Multi-Center Analysis of RENAL, mRENAL, and (MC)2 Scoring Systems as Predictors of Outcomes After Percutaneous Cryoablation of Renal Cell Carcinoma.

Abstract

Purpose: This study compares the performance of the RENAL, mRENAL and (MC)² scores in predicting outcomes after RCC cryoablation.

Materials and methods: Retrospective chart review was performed for patients who underwent cryoablation within a hospital system between 2018 and 2023. 103 cryoablation procedures in 103 patients were included. Medical history, demographic information, pre-procedural imaging, tumor characteristics, peri-procedural hospital course, post-procedure adverse events, and follow-up imaging results were reviewed. Each tumor was assigned a RENAL, mRENAL, and (MC)² score and categorized into a low, medium, or high group for each scoring system.

Results: Twenty-one patients (20.5%) developed SIR Graded adverse events. Severe adverse events occurred in nine patients (8.7%). High RENAL (p = .003), mRENAL (p = .047), and (MC)² (p = .004) scores were all associated with a significant increase in the risk of severe post-procedural adverse events. All three scoring systems were equivalent in their ability to predict severe adverse events. Higher RENAL (p = .018, .019) and mRENAL (p = .007, .005) but not (MC)² scores were associated with increased likelihood of unplanned hospital admission and longer hospital length of stay. RENAL, mRENAL and (MC)² scores were not significantly associated with primary technique effectiveness.

Conclusion: The RENAL, mRENAL, and (MC)² scores performed equally in predicting severe adverse events after cryoablation. The RENAL and mRENAL scores predicted post-procedure hospital admission and hospital LOS more effectively than (MC)². The scoring systems were not predictive of primary technique effectiveness despite a trend toward lower effectiveness in tumors with higher scores.