Impact of tumor histology and grade on treatment success of percutaneous renal cryoablation

Alp Tuna Beksac, Gerant Rivera-Sanfeliz, Catherine A. Dufour, Unwanaobong Nseyo, Zachary Hamilton, Sean W. Berquist, Abd el Rahman Hassan, Omer A. Raheem, Song Wang, Robert Wake, Robert Gold, Ithaar H. Derweesh

Research output: Contribution to journalArticle

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Abstract

Background: We analyzed oncological outcomes in patients who underwent percutaneous renal cryoablation (PRC) with documented renal cell carcinoma (RCC) by perioperative biopsy. Methods: Multicenter retrospective analysis of 153 patients [median follow-up 48 months] who underwent PRC from 09/2005 to 08/2014 was performed. We divided the cohort into patients who developed recurrence versus no recurrence. Kaplan–Meier analyses examined recurrence-free survival (RFS) according to grade and histology. Multivariable analysis (MVA) was performed to identify factors associated with tumor recurrence. Results: One hundred and fifty-three patients were analyzed [18 patients (11.8 %) with recurrence and 135 (88.2 %) patients without recurrence]. There were no differences between the groups with respect to demographics, RENAL score, and number of probes utilized. Recurrence group had larger tumor size (3.1 vs. 2.4 cm; p = 0.011), upper pole tumor location (p = 0.016), and greater proportions of high-grade tumor (33 vs. 0.7 %; p < 0.001) and clear cell histology (77.8 vs. 45.9 %; p = 0.011). Four-year RFS was 100 versus 80 % for grade 1 versus grade 2/3 tumors (p = 0.0002), and 97 versus 88 % for other RCC versus clear cell RCC (p = 0.07). MVA demonstrated tumor size >3 cm (OR 2.46; p = 0.019), clear cell histology (OR 2.12; p = 0.027), and high tumor grade (OR 2.33, p < 0.001) as independent risk factors associated with tumor recurrence. Conclusions: Association of higher grade and clear cell histology with recurrence and progression suggests need for increased emphasis on preoperative risk stratification by biopsy, with grade 1 and non-clear cell RCC being associated with improved treatment success than higher grade and clear cell RCC.

Original languageEnglish (US)
Pages (from-to)633-640
Number of pages8
JournalWorld Journal of Urology
Volume35
Issue number4
DOIs
StatePublished - Apr 1 2017

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Cryosurgery
Histology
Kidney
Recurrence
Neoplasms
Renal Cell Carcinoma
Therapeutics
Biopsy
Demography
Survival

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Beksac, A. T., Rivera-Sanfeliz, G., Dufour, C. A., Nseyo, U., Hamilton, Z., Berquist, S. W., ... Derweesh, I. H. (2017). Impact of tumor histology and grade on treatment success of percutaneous renal cryoablation. World Journal of Urology, 35(4), 633-640. https://doi.org/10.1007/s00345-016-1911-6

Impact of tumor histology and grade on treatment success of percutaneous renal cryoablation. / Beksac, Alp Tuna; Rivera-Sanfeliz, Gerant; Dufour, Catherine A.; Nseyo, Unwanaobong; Hamilton, Zachary; Berquist, Sean W.; Hassan, Abd el Rahman; Raheem, Omer A.; Wang, Song; Wake, Robert; Gold, Robert; Derweesh, Ithaar H.

In: World Journal of Urology, Vol. 35, No. 4, 01.04.2017, p. 633-640.

Research output: Contribution to journalArticle

Beksac, AT, Rivera-Sanfeliz, G, Dufour, CA, Nseyo, U, Hamilton, Z, Berquist, SW, Hassan, AER, Raheem, OA, Wang, S, Wake, R, Gold, R & Derweesh, IH 2017, 'Impact of tumor histology and grade on treatment success of percutaneous renal cryoablation', World Journal of Urology, vol. 35, no. 4, pp. 633-640. https://doi.org/10.1007/s00345-016-1911-6
Beksac AT, Rivera-Sanfeliz G, Dufour CA, Nseyo U, Hamilton Z, Berquist SW et al. Impact of tumor histology and grade on treatment success of percutaneous renal cryoablation. World Journal of Urology. 2017 Apr 1;35(4):633-640. https://doi.org/10.1007/s00345-016-1911-6
Beksac, Alp Tuna ; Rivera-Sanfeliz, Gerant ; Dufour, Catherine A. ; Nseyo, Unwanaobong ; Hamilton, Zachary ; Berquist, Sean W. ; Hassan, Abd el Rahman ; Raheem, Omer A. ; Wang, Song ; Wake, Robert ; Gold, Robert ; Derweesh, Ithaar H. / Impact of tumor histology and grade on treatment success of percutaneous renal cryoablation. In: World Journal of Urology. 2017 ; Vol. 35, No. 4. pp. 633-640.
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abstract = "Background: We analyzed oncological outcomes in patients who underwent percutaneous renal cryoablation (PRC) with documented renal cell carcinoma (RCC) by perioperative biopsy. Methods: Multicenter retrospective analysis of 153 patients [median follow-up 48 months] who underwent PRC from 09/2005 to 08/2014 was performed. We divided the cohort into patients who developed recurrence versus no recurrence. Kaplan–Meier analyses examined recurrence-free survival (RFS) according to grade and histology. Multivariable analysis (MVA) was performed to identify factors associated with tumor recurrence. Results: One hundred and fifty-three patients were analyzed [18 patients (11.8 {\%}) with recurrence and 135 (88.2 {\%}) patients without recurrence]. There were no differences between the groups with respect to demographics, RENAL score, and number of probes utilized. Recurrence group had larger tumor size (3.1 vs. 2.4 cm; p = 0.011), upper pole tumor location (p = 0.016), and greater proportions of high-grade tumor (33 vs. 0.7 {\%}; p < 0.001) and clear cell histology (77.8 vs. 45.9 {\%}; p = 0.011). Four-year RFS was 100 versus 80 {\%} for grade 1 versus grade 2/3 tumors (p = 0.0002), and 97 versus 88 {\%} for other RCC versus clear cell RCC (p = 0.07). MVA demonstrated tumor size >3 cm (OR 2.46; p = 0.019), clear cell histology (OR 2.12; p = 0.027), and high tumor grade (OR 2.33, p < 0.001) as independent risk factors associated with tumor recurrence. Conclusions: Association of higher grade and clear cell histology with recurrence and progression suggests need for increased emphasis on preoperative risk stratification by biopsy, with grade 1 and non-clear cell RCC being associated with improved treatment success than higher grade and clear cell RCC.",
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AU - Rivera-Sanfeliz, Gerant

AU - Dufour, Catherine A.

AU - Nseyo, Unwanaobong

AU - Hamilton, Zachary

AU - Berquist, Sean W.

AU - Hassan, Abd el Rahman

AU - Raheem, Omer A.

AU - Wang, Song

AU - Wake, Robert

AU - Gold, Robert

AU - Derweesh, Ithaar H.

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