Percutaneous Clinical T<inf>1a</inf> Renal Mass Ablation in the Octogenarian and Nonagenarian: Oncologic Outcomes and Morbidity

Andrew J. Miller, A. Nicholas Kurup, Grant D. Schmit, Adam J. Weisbrod, Stephen A. Boorjian, R. Houston Thompson, Christine M. Lohse, Daryl J Kor, Matthew R Callstrom, Thomas D. Atwell

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Abstract

Purpose: To evaluate outcomes of percutaneous ablation of small renal tumors in the elderly population. Patients and Methods: Using our tumor ablation database, we searched for percutaneous ablation procedures for clinical T<inf>1a</inf> renal masses in octogenarians and nonagenarians between June 2001 and May 2012. Altogether, 105 tumors from 99 procedures among 95 patients (mean age 84.0±3.0 years, range 80-92) were identified. Oncologic outcomes and major complications were evaluated. Assessment also included patient hospital stays and renal functional outcomes. Results: Technical success was achieved in 60/61 (98.4%) tumors managed with cryoablation and 43/44 (97.7%) after radiofrequency ablation (RFA). Of 87 renal tumors with at least 3 months imaging follow-up, 2 (5.4%) tumors progressed at 1.2 and 2.2 years after RFA. None recurred after cryoablation. Estimated progression-free survival rates at 1, 3, and 5 years after ablation were 99%, 97%, and 97%, respectively. Thirty-four patients died at a mean of 3.7 years after ablation (median 3.7; range 0.4-9.6). Estimated overall survival rates were 98%, 83%, and 61%, respectively. Among 33 patients with sporadic, biopsy-proven renal-cell carcinoma, estimated cancer-specific survival rates were 100%, 100%, and 86%, respectively. Five (8.6%) major complications developed after renal cryoablation with no (0%) major complication after RFA. Mean decrease in serum creatinine level within 1 week after ablation was 0.1mg/dL. Mean hospitalization was 1.2 days. Conclusion: Percutaneous thermal ablation is safe and effective in the active management of clinical T<inf>1a</inf> renal masses in elderly patients. These results should help urologists appropriately assess expected outcomes when counseling octogenarian and nonagenarian patients.

Original languageEnglish (US)
Pages (from-to)671-676
Number of pages6
JournalJournal of Endourology
Volume29
Issue number6
DOIs
StatePublished - Jun 1 2015

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ASJC Scopus subject areas

  • Urology

Cite this

Miller, A. J., Kurup, A. N., Schmit, G. D., Weisbrod, A. J., Boorjian, S. A., Thompson, R. H., Lohse, C. M., Kor, D. J., Callstrom, M. R., & Atwell, T. D. (2015). Percutaneous Clinical T<inf>1a</inf> Renal Mass Ablation in the Octogenarian and Nonagenarian: Oncologic Outcomes and Morbidity. Journal of Endourology, 29(6), 671-676. https://doi.org/10.1089/end.2014.0733