Irreversible electroporation of small renal masses: suboptimal oncologic efficacy in an early series

Noah Canvasser, Igor Sorokin, Aaron H. Lay, Monica S.C. Morgan, Asim Ozayar, Clayton Trimmer, Jeffrey A. Cadeddu

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Purpose: To report on the first short-term oncologic outcomes of percutaneous irreversible electroporation for small renal masses. Methods: Patients with cT1a renal masses treated with irreversible electroporation from April 2013 through December 2016 were reviewed. Small, low complexity tumors were generally selected for irreversible electroporation using the NanoKnife® System (Angiodynamics, Latham, NY, USA). Surveillance imaging was performed post-operatively, and survival analysis was completed using the Kaplan–Meier method. Results: A total of 42 tumors in 41 patients underwent irreversible electroporation. Mean tumor size was 2.0 cm with a median R.E.N.A.L nephrometry score of 5. Twenty-nine patients (71%) were discharged the same day of the procedure and no major (Clavien grade II or higher) intraoperative or post-operative complications occurred. Initial treatment success rate was 93%; our three failures (7%) underwent salvage radiofrequency ablation. With a mean follow-up of 22 months, 2-year local recurrence-free survival was 83% for patients with biopsy confirmed renal cell carcinoma, 87% with biopsy confirmed or a history of renal cell carcinoma, and 92% for the intent-to-treat cohort. Conclusions: Although with low morbidity, in comparison to extirpation and conventional thermal ablation technologies, irreversible electroporation has suboptimal short-term local disease control results in this series of small, low complexity tumors. Larger series and longer follow-up will determine the durability of this modality.

Original languageEnglish (US)
Pages (from-to)1549-1555
Number of pages7
JournalWorld Journal of Urology
Volume35
Issue number10
DOIs
StatePublished - Oct 1 2017
Externally publishedYes

Keywords

  • Carcinoma
  • Complications
  • Electroporation
  • Kidney neoplasms
  • Renal cell
  • Survival rate

ASJC Scopus subject areas

  • Urology

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