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Thermal Ablation Combined with Selective Transarterial Embolization of Centrally Located Renal Cell Carcinomas Measuring 3 cm or Larger

  • Technical Note
  • Interventional Oncology
  • Published:
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Abstract

Purpose

The purpose of this study was to evaluate the long-term outcomes of patients with centrally located renal cell carcinomas (RCC) measuring 3 cm or larger, treated by a standardized transarterial embolization protocol associated with percutaneous ablation.

Materials and Methods

This retrospective study included 11 patients (73% male, mean age 73.4 ± 6.5 years) with RCC and contraindications for surgery. All patients underwent a single session combining transarterial embolization with iodized oil and subsequent thermal percutaneous ablation. Primary and secondary local tumor control were analyzed, defined as absence of any contrast enhancing nodular lesion in the treated area after a single or percutaneous re-treatment session, respectively.

Results

Mean tumor size was 3.5 ± 0.3 cm (range 3–4 cm) with a mean R.E.N.A.L. nephrometry score ((R)adius; (E)xophytic, endophytic properties; (N)earness to the collecting system; (A)nterior, posterior; (L)ocation relative to the polar line) of 8 ± 0.9 (range 7–9). Nearness to the collecting system was 4–7 mm in two patients (18%) and ≤ 4 mm in nine patients (82%). After a mean follow-up of 5.2 ± 2.5 years primary and secondary local tumor control rate were 82% and 100%, respectively. No change in serum creatinine levels and glomerular filtration rate was observed compared to pre-treatment values.

Conclusion

A combined treatment of selective transarterial embolization and percutaneous ablation of large centrally located RCC (> 3 cm) is safe, feasible and can achieve excellent oncological long-term results. Larger prospective studies are needed.

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Abbreviations

CT:

Computed tomography

DSA:

Digital subtraction angiography

GFR:

Glomerular filtration rate

MDCT:

Multidetector computed tomography

MRI:

Magnetic resonance imaging

RCC:

Renal cell carcinoma

RFA:

Radiofrequency ablation

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Interventional Radiology, Gustave Roussy–Cancer Center, 114 Rue Edouard Vaillant, 94805, Villejuif, France

    Adrian Kobe, Lambros Tselikas, Frédéric Deschamps, Charles Roux, Alexandre Delpla, Eloi Varin, Antoine Hakime & Thierry de Baère

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  1. Adrian Kobe
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  2. Lambros Tselikas
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  3. Frédéric Deschamps
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  4. Charles Roux
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  5. Alexandre Delpla
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  7. Antoine Hakime
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  8. Thierry de Baère
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Correspondence to Adrian Kobe.

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Kobe, A., Tselikas, L., Deschamps, F. et al. Thermal Ablation Combined with Selective Transarterial Embolization of Centrally Located Renal Cell Carcinomas Measuring 3 cm or Larger. Cardiovasc Intervent Radiol 45, 371–379 (2022). https://doi.org/10.1007/s00270-021-03036-4

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  • DOI: https://doi.org/10.1007/s00270-021-03036-4

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