Irreversible electroporation for surgical renal masses in solitary kidneys

• Verfasst von: Diehl, Steffen J. [VerfasserIn]
• Verfasst von: Rathmann, Nils-Andreas [VerfasserIn]
• Verfasst von: Kostrzewa, Michael [VerfasserIn]
• Verfasst von: Ritter, Manuel [VerfasserIn]
• Verfasst von: Smakic, Arman [VerfasserIn]
• Verfasst von: Schönberg, Stefan [VerfasserIn]
• Verfasst von: Kriegmair, Maximilian [VerfasserIn]
• Titel: Irreversible electroporation for surgical renal masses in solitary kidneys
• Titelzusatz: short-term interventional and functional outcome
• Verf.angabe: Steffen J. Diehl, MD, Nils Rathmann, MD, Michael Kostrzewa, MD, Manuel Ritter, MD, Arman Smakic, MD, Stefan O. Schoenberg, MD, and Maximilian C. Kriegmair, MD
• E-Jahr: 2016
• Jahr: September 2016
• Umfang: 7 S.
• Fussnoten: Gesehen am 05.08.2019 ; Available online 9 June 2016
• Titel Quelle: Enthalten in: Journal of vascular and interventional radiology
• Ort Quelle: Amsterdam [u.a.] : Elsevier, 1990
• Jahr Quelle: 2016
• Band/Heft Quelle: 27(2016), 9, Seite 1407-1413
• ISSN Quelle: 1535-7732
• DOI: doi:10.1016/j.jvir.2016.03.044
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 167056648X

Abstract

Purpose - To examine short-term outcomes and complications in patients with a solitary kidney treated with irreversible electroporation (IRE) for a potentially malignant renal mass. - Materials and Methods - Five patients (2 female, 3 male; mean age, 66 y) with 7 lesions who underwent IRE for renal tumors in a solitary kidney between August 2014 and August 2015 were retrospectively reviewed. Changes in signal intensity (SI) of the treated lesion were evaluated on contrast-enhanced magnetic resonance imaging. To evaluate functional outcome, creatinine levels and estimated glomerular filtration rate (eGFR) were compared vs baseline after 1 day, 2-7 days, 3-6 weeks, and 6-12 weeks after the intervention. - Results - Mean tumor diameter was 24.4 mm (range, 15-38 mm), with an average score of 7.7 (range, 4-9) per R.E.N.A.L. criteria (radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, and location relative to polar lines). There was a progressive, significant decrease in treated tumor SI on follow-up imaging (mean, 70%-82%), suggesting a treatment response rate of 100% at a mean follow-up of 6.4 months (range, 3-11 mo). Two minor acute complications (Society of Interventional Radiology class A) occurred: transient gross hematuria and stage I acute kidney failure. Overall, there was no significant decrease in eGFR (−2.75 mL/min) over 3 months, even though 1 patient’s eGFR decreased from > 60 mL/min/1.73m2 to 44 mL/min/1.73m2. - Conclusions - The data suggest that percutaneous IRE for renal mass in patients with a solitary kidney is safe and feasible. It may help to preserve renal function and offers promising short-term oncologic results.