Multi-Institutional Analysis Of Risk Factors For Complications Following Thermal Ablation For Small Renal Masses

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy II (PD16)1 Sep 2021PD16-09 MULTI-INSTITUTIONAL ANALYSIS OF RISK FACTORS FOR COMPLICATIONS FOLLOWING THERMAL ABLATION FOR SMALL RENAL MASSES Kimberly Maciolek, Clinton Yeaman, Arighno Das, Leo Dreyfuss, Nicole Curci, Tim McClure, Matthew Davenport, Elaine Caoili, Glenn Allen, Shane Wells, Tudor Borza, E. Jason Abel, and Stephen Culp Kimberly MaciolekKimberly Maciolek More articles by this author , Clinton YeamanClinton Yeaman More articles by this author , Arighno DasArighno Das More articles by this author , Leo DreyfussLeo Dreyfuss More articles by this author , Nicole CurciNicole Curci More articles by this author , Tim McClureTim McClure More articles by this author , Matthew DavenportMatthew Davenport More articles by this author , Elaine CaoiliElaine Caoili More articles by this author , Glenn AllenGlenn Allen More articles by this author , Shane WellsShane Wells More articles by this author , Tudor BorzaTudor Borza More articles by this author , E. Jason AbelE. Jason Abel More articles by this author , and Stephen CulpStephen Culp More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001998.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Thermal ablation (TA) is an established treatment for small renal cell carcinomas (RCC). Prior studies are limited by study size. The present study represents a collaboration between 4 academic institutions to understand the perioperative outcomes and risk factors for complications after TA. METHODS: Retrospective review of multi-institution experience with TA was performed to evaluate rates of complications and readmission for patients undergoing TA for RCC. Clinical, procedural and follow up data were collected. Major complications were defined as Clavien-Dindo ≥3. Univariate and stepwise multivariate logistic regression models were used to identify factors predictive of any and major post-procedure complication. RESULTS: We identified 851 patients undergoing TA from all 4 institutions for which complication data were available. Median age was 68.5 years (Interquartile range (IQR) 60.7, 75.0) with 66.5% being male. Median body mass index (BMI) was 30.6 (IQR 26.48, 25.7). Median Charlson Comorbidity Index (CCI) was 4 (IQR 2, 5). A total of 112 ablations (13.2%) had a post-procedure complication with 31 (3.6%) major complications. On univariate analysis, R.E.N.A.L. nephrometry score, maximum tumor diameter and number of probes were each significantly associated with any complication and major complications (Table 1). On multivariate analysis, only maximum tumor diameter was significantly associated with any (OR 1.33; 95% CI 1.14, 1.55) or major (OR 1.42; 95% CI 1.15, 1.76) complication. Although blood transfusion (6/543, 1.1%) and readmission (23/685, 3.4%) rates were low, both were significantly associated with occurrence of any or major complications as well as maximum tumor size (p<0.05). Patient age, gender, CCI or BMI were not associated with complication, transfusion and readmission (Table 1). CONCLUSIONS: TA is a safe treatment of RCC resulting in low complication, transfusion and readmission rates. As with other nephron-sparing modalities, increased tumor size and complexity were associated with higher complication risks which then correlated with need for blood transfusion and readmission. However, patient age, gender and CCI did not influence complication risk which is important given that ablation patients typically are older and have multiple comorbidities. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e281-e282 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kimberly Maciolek More articles by this author Clinton Yeaman More articles by this author Arighno Das More articles by this author Leo Dreyfuss More articles by this author Nicole Curci More articles by this author Tim McClure More articles by this author Matthew Davenport More articles by this author Elaine Caoili More articles by this author Glenn Allen More articles by this author Shane Wells More articles by this author Tudor Borza More articles by this author E. Jason Abel More articles by this author Stephen Culp More articles by this author Expand All Advertisement PDF downloadLoading ...