A retrospective study of CT-guided percutaneous irreversible electroporation (IRE) ablation: clinical efficacy and safety

To evaluate the clinical efficacy and safety of ablating renal cell carcinoma (RCC) by irreversible electroporation (IRE). Fifteen patients (19 lesions) with RCC who underwent IRE were retrospectively reviewed. Seven patients had solitary kidneys. Two lesions were located in the renal hilus. One pat...

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Published in:	BMC cancer Vol. 21; no. 1; p. 124
Main Authors:	Wang, Ziyin, Lu, Jian, Huang, Wei, Wu, Zhiyuan, Gong, Ju, Wang, Qingbing, Liu, Qin, Wang, Cangyi, Zhu, Yu, Ding, Xiaoyi, Wang, Zhongmin
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 05-02-2021 BioMed Central BMC
Subjects:	Ablation Ablation (Surgery) Ablation techniques Ablation Techniques - methods Aged Apoptosis Biopsy Blood tests Carcinoma Carcinoma, Renal cell Carcinoma, Renal Cell - diagnostic imaging Carcinoma, Renal Cell - pathology Carcinoma, Renal Cell - surgery Cardiovascular disease Care and treatment Computed tomography CT imaging Electrodes Electroporation Electroporation - methods Endophytes Epidermal growth factor receptors Female Follow-Up Studies General anesthesia Glomerular Filtration Rate Hematoma Hematuria Hemoglobin Histopathology Humans Kidney cancer Kidney Neoplasms - diagnostic imaging Kidney Neoplasms - pathology Kidney Neoplasms - surgery Lesions Male Medical imaging Metastases Metastasis Methods Middle Aged Patients Radiofrequency ablation Renal cell Renal cell carcinoma Renal insufficiency Retrospective Studies Statistical analysis Surgery, Computer-Assisted - methods Tomography, X-Ray Computed - methods Treatment Outcome Tumors China Carcinoma Computed tomography Renal cell Ablation techniques
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Summary:	To evaluate the clinical efficacy and safety of ablating renal cell carcinoma (RCC) by irreversible electroporation (IRE). Fifteen patients (19 lesions) with RCC who underwent IRE were retrospectively reviewed. Seven patients had solitary kidneys. Two lesions were located in the renal hilus. One patient had chronic renal insufficiency. Percutaneous biopsy for histopathology was performed. The best puncture path plan was evaluated before CT-guided IRE. The estimated glomerular filtration rate (eGFR) was compared vs baseline at 1-2 months after the ablation. Contrast-enhanced computed tomography imaging changes were evaluated immediately after IRE. Contrast-enhanced computed tomography/magnetic resonance was performed 1 month, 3 months, 6 months, 12 months and every year thereafter. The complications after treatment were also reviewed. The success rate of the procedure was 100%. The median tumor size was 2.4 (IQR 1.3-2.9) cm, with an median score of 6 (IQR 5.5-8) per R.E.N.A.L. criteria (radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, and location relative to polar lines). Two cases (3 lesions) were punctured through the liver. In other cases, puncture was performed through the perirenal space. There were no severecomplications in interventional therapy. Transient gross hematuria occurred in 2 patients (centrally located). Self-limiting perinephric hematomas occurred in 1 patient. Needle puncture path metastasis was found in 1 patient 2.5 years after IRE. The subcutaneous metastasis was surgically removed, and there was no evidence of recurrence. There was no significant change in eGFR levels in terms of short- term clinical outcomes (t = 0.348, P = 0.733). At 6 months, all 15 patients with imaging studies available had no evidence of recurrence. At 1 year, 1 patient (1 of 15) was noted to have experienced needle tract metastasis and accepted salvage radiofrequency ablation (RFA) therapy. IRE appears to be a safe and effective treatment for RCC that may offer a tissue-sparing method and complete ablation as an alternative therapy for RCC.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1471-2407 1471-2407
DOI:	10.1186/s12885-021-07820-w