scholarly journals Trans-Arterial Embolization of Renal Cell Carcinoma prior to Percutaneous Ablation: Technical Aspects, Institutional Experience, and Brief Review of the Literature

2018 ◽  
Vol 12 (1) ◽  
pp. 43-49 ◽  
Author(s):  
Andrew J. Gunn ◽  
Benjamin J. Mullenbach ◽  
May M. Poundstone ◽  
Jennifer B. Gordetsky ◽  
Edgar S. Underwood ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Arterial Embolization ◽  
Common Femoral Artery ◽  
Percutaneous Ablation ◽  
Tumor Diameter ◽  
Technical Aspects ◽  
Ethiodized Oil ◽  
Embolic Materials

This report describes the technical aspects of trans-arterial embolization (TAE) of renal cell carcinoma prior to percutaneous ablation. All patients (n = 11) had a single renal mass (mean tumor diameter = 50.2 mm; range: 28-84 mm). Selective TAE was performed via the common femoral artery. Embolic materials included: particles alone (n = 4), coils alone (n = 1), particles + ethiodized oil (n = 2), particles + coils (n = 1), ethiodized oil + ethanol (n = 2), and particles + ethanol (n = 1). All embolizations were technically successful and no complications have been reported. After embolization, 10 patients underwent cryoablation while 1 patient underwent microwave ablation. Ablations were technically successful in 10 of the 11 patients. Only 3 minor complications were identified but none required treatment. No adverse effect on the patient's glomerular filtration rate was seen from the additional procedure (p = 0.84). TAE of renal cell carcinoma prior to percutaneous ablation is safe and technically-feasible.

Evaluation of therapeutic arterial embolization in renal cell carcinoma using microencapsulated mitomycin C

Urology ◽  
1981 ◽  
Vol 17 (4) ◽  
pp. 315-319 ◽  
Author(s):  
Ryosuke Nemoto ◽  
Tetsuro Kato ◽  
Katsuo Iwata ◽  
Katsuo Iwata ◽  
Hisashi Mori ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Mitomycin C ◽  
Renal Cell ◽  
Arterial Embolization

Imaging-Guided Percutaneous Ablation of Renal Cell Carcinoma: A Primer of How We Do It

2009 ◽  
Vol 192 (6) ◽  
pp. 1558-1570 ◽  
Author(s):  
Raul N. Uppot ◽  
Stuart G. Silverman ◽  
Ronald J. Zagoria ◽  
Kemal Tuncali ◽  
David D. Childs ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Percutaneous Ablation

scholarly journals Quantification of contrast-uptake as imaging biomarker for disease progression of renal cell carcinoma after tumor ablation

2020 ◽  
Vol 61 (12) ◽  
pp. 1708-1716
Author(s):  
Bruno R Tegel ◽  
Steffen Huber ◽  
Lynn J Savic ◽  
MingDe Lin ◽  
Bernhard Gebauer ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Tumor Volume ◽  
Cox Regression ◽  
Imaging Biomarker ◽  
Imaging Biomarkers ◽  
Secondary Outcome ◽  
Tumor Diameter ◽  
Renal Metastases

Background The prognosis of patients with renal cell carcinoma (RCC) depends greatly on the presence of extra-renal metastases. Purpose To investigate the value of total tumor volume (TTV) and enhancing tumor volume (ETV) as three-dimensional (3D) quantitative imaging biomarkers for disease aggressiveness in patients with RCC. Material and Methods Retrospective, HIPAA-compliant, IRB-approved study including 37 patients with RCC treated with image-guided thermal ablation during 2007–2015. TNM stage, RENAL Nephrometry Score, largest tumor diameter, TTV, and ETV were assessed on cross-sectional imaging at baseline and correlated with outcome measurements. The primary outcome was time-to-occurrence of extra-renal metastases and the secondary outcome was progression-free survival (PFS). Correlation was assessed using a Cox regression model and differences in outcomes were shown by Kaplan–Meier plots with significance and odds ratios (OR) calculated by Log-rank test/generalized Wilcoxon and continuity-corrected Woolf logit method. Results Patients with a TTV or ETV > 5 cm3 were more likely to develop distant metastases compared to patients with TTV (OR 6.69, 95% confidence interval [CI] 0.33–134.4, P=0.022) or ETV (OR 8.48, 95% CI 0.42–170.1, P=0.016) < 5 cm3. Additionally, PFS was significantly worse in patients with larger ETV ( P = 0.039; median PFS 51.87 months vs. 69.97 months). In contrast, stratification by median value of the established, caliper-based measurements showed no significant correlation with outcome parameters. Conclusion ETV, as surrogate of lesion vascularity, is a sensitive imaging biomarker for occurrence of extra-renal metastatic disease and PFS in patients with RCC.

scholarly journals Society of Interventional Radiology Position Statement on the Role of Percutaneous Ablation in Renal Cell Carcinoma

2020 ◽  
Vol 31 (2) ◽  
pp. 189-194.e3 ◽  
Author(s):  
Christopher S. Morris ◽  
Mark O. Baerlocher ◽  
Sean R. Dariushnia ◽  
Eric D. McLoney ◽  
Nadine Abi-Jaoudeh ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Interventional Radiology ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Position Statement ◽  
Percutaneous Ablation

Phase II trial of vandetanib in Von Hippel-Lindau-associated renal cell carcinoma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4584-4584
Author(s):  
Lambros Stamatakis ◽  
Brian Shuch ◽  
Eric A. Singer ◽  
Jeffrey Nix ◽  
Hong Truong ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Adverse Events ◽  
Cell Carcinoma ◽  
Disease Progression ◽  
Phase Ii ◽  
Renal Cell ◽  
Significant Proportion ◽  
Tumor Diameter ◽  
Cell Renal Cell Carcinoma ◽  
Von Hippel Lindau

4584 Background: Germline mutations in the von Hippel Lindau (VHL) gene are associated with the development of bilateral multifocal clear-cell renal cell carcinoma (RCC). VHL patients with localized disease are surgically managed, with nephron sparing resection recommended once tumors reach 3 cm. Patients typically undergo multiple surgeries with significant cumulative morbidity. In this phase 2 trial of vandetanib, a dual VEGFR2/EGFR inhibitor, a systemic approach to these tumors was explored. Methods: Patients with VHL-associated RCC were treated with 300 mg vandetanib daily until disease progression or unacceptable toxicity. Cross sectional imaging was performed at baseline and every 12 weeks. The primary endpoint was overall renal tumor response assessed by RECIST. Results: A total of 34 subjects were enrolled, with a mean age of 47 years (range 28 – 72). The median number of targeted lesions per subject was 2 (range 1 – 6) and the mean tumor diameter was 2.3 cm (range 1.2 – 4.0). Twenty-seven (80%) subjects had baseline imaging and at least one follow-up study to allow response evaluation. Median time on study was 6.1 months (range 1.0 – 23.3). Thirteen (38%) subjects demonstrated overall reduction in tumor burden with a median reduction of 6% (range 4-54%). One (3%) subject had a PR by RECIST and 26 (77%) had stable disease as their best response. Eleven (32%) subjects were taken off study due to growth of at least one lesion that met criteria for surgical resection or disease progression. Nine (27%) subjects required dose reductions due to toxicity. Although the majority of adverse events encountered on trial were grade 2 or less, 9 (27%) subjects were taken off trial due to drug-related toxicities and 9 (27%) withdrew due to intolerable side effects. Rash (71%), and QTc prolongation (41%) were the most common adverse events noted. Conclusions: In the largest phase II study of a systemic agent for VHL-related RCC, vandetanib demonstrated anti-tumor activity. Despite a reasonable safety profile, poor tolerability necessitated drug withdrawal in a significant proportion of patients. Newer agents that selectively target the VEGF receptors may offer a more tolerable alternative and might optimize clinical benefits in this population. Clinical trial information: NCT0056695.

scholarly journals Brief communication (Original). Predictive factors for postoperative complications in radical nephrectomy for renal cell carcinoma

2014 ◽  
Vol 8 (6) ◽  
pp. 763-769
Author(s):  
Non Wongvittavas ◽  
Kamol Panumatrassamee ◽  
Julin Opanuraks ◽  
Manint Usawachintachit ◽  
Supoj Ratchanon ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Multivariate Analysis ◽  
Postoperative Complications ◽  
Cell Carcinoma ◽  
Predictive Factors ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Tumor Diameter ◽  
Asa Score ◽  
Major Complications

Abstract Background: Radical nephrectomy is the treatment of choice for large renal cell carcinoma (RCC). Objectives: To describe the complications after radical nephrectomy for suspected or proven RCC and analyze the risk factors. Materials and methods: We retrospectively reviewed medical records from 110 patients who underwent radical nephrectomy for RCC in our institution between January 2007 and December 2013. The clinicopathological data of all patients were recorded and complications were graded using modified Clavien classification. Univariate and multivariate analysis was made of the predictive factors for complications. Results: Fifty postoperative complications occurred in 34 patients (31%) within 30 days, including 11% transfusion related complications. There were 22% minor complications (6% grade 1, 16% grade 2) and 9% major complication (5% grade 3, 2% grade 4, and 2% grade 5). The most common complications were transfusion-related, re-laparotomy because of bleeding, and prolong ileus. In univariate analysis, pathological T-stage (P = 0.001), American Society of Anesthesiologists (ASA) score (P = 0.007), tumor size (P = 0.01), and tumor diameter >4 cm (P = 0.03) were significant predicting factors. Major Charlson comorbidity index (CCI >2) was the only significant factor for major complications (P = 0.04). In multivariate analysis, ASA score was a significant independent predictor for overall complications (odds ratio 4.83, P = 0.01). Conclusions: ASA score was a significant predictive factor for overall postoperative complications. Comorbidities was also a predictor for major complications in radical nephrectomy. Preoperative risk stratification for complications should be considered during decision-making and for proper counseling of patients.

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