Long-term durable oncologic outcomes after radiofrequency ablation for T1 renal cell carcinoma.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 384-384 ◽  
Author(s):  
Sarah P. Psutka ◽  
Francis J. McGovern ◽  
Peter Mueller ◽  
W. Scott McDougal ◽  
Debra Gervais ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Radiofrequency Ablation ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Disease Free Survival ◽  
Oncologic Outcomes ◽  
Free Survival ◽  
Disease Free

384 Background: Long-term oncologic outcomes for radiofrequency ablation (RFA) of renal cell carcinoma (RCC) are limited. The objective of this study was to assess the long-term oncological efficacy of RFA for treatment of renal cell carcinoma. Methods: Between 1998 and 2008, 311 biopsy-proven RCC were treated with RFA in 274 patients. Exclusion criteria included history of prior RCC or known metastatic RCC at time of RFA (n=92). 26 patients were lost to follow-up prior to their 6-month imaging study. We retrospectively reviewed the long-term oncologic outcomes for 193 patients. Mean follow-up was 4.6 yrs (range 1–12, SD 2.3). Results: Median age was 71 years (IQR: 63 –79 years). Median Charlson Score was 5.46 (IQR: 5–6). Median size of tumor treated was 3 cm (IQR: 2–3.9 cm, range 1–7.1cm) and 64 of these tumors (33%) were endophytic. Tumor breakdown by stage was T1a: n=153 (79%), T1b: n=37 (19%), and T2: n=3 (2%). Initial treatment success rate was 89%. There were 6 local recurrences (3%) in 4 patients with T1b disease and 2 patients with T2 disease with an average time-to-recurrence of 2.9 years (SD 0.7). 95% of patients with T1a RCC were disease free at last follow-up, in comparison to 81% of those with T1b and 33% of those with T2 disease (p=0.008). At last follow-up 178 (92%) patients were disease-free. 16 (8.2%) developed metastatic disease and 4 patients (2%) died of RCC. Mean disease-free survival was 4.3 years (SD 2.4). Conclusions: In patients who are poor surgical candidates, RFA results in durable local control and a low risk of disease recurrence in T1 RCC. Higher stage, however, correlates with a decreased disease free survival and alternate treatments should be considered when counseling these patients.

Adjuvant therapy with alpha-interferon in radically resected stage Il and III renal cell carcinoma

1992 ◽  
Vol 59 (1_suppl) ◽  
pp. 160-162
Author(s):  
◽  
Urologico Lombardo
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Randomized Study ◽  
Disease Free Survival ◽  
Stage Ii ◽  
Alpha Interferon ◽  
Free Survival ◽  
Resected Stage

In February 1990, a multicentric randomized study was started to verify the therapeutic efficacy of adjuvant alpha-interferon in Robson's stage II and III renal cell carcinoma. Up to April 1992, 749 radical nephrectomies have been recorded by the 25 participating centers. Stage II and III patients fullfilling selection criteria were 124: 64 were assigned to Interferon therapy and 60 to control. The short follow-up does not allow any evaluation of the relapse rate. Therapy related toxicity was represented by mild fever and flu-like syndrome in 50% of cases and slight leucopenia in 5%. The recruitment of the first 200 randomized patients will end approximately within 1 year. While evaluating the hypothesis of a 20% difference in the 5 year disease-free survival between the two groups recruitment will continue up to a total of 350 cases, in order to verify the 15% hypothesis, too.

scholarly journals Predictive Ability for Disease-Free Survival of the GRade, Age, Nodes, and Tumor (GRANT) Score in Patients with Resected Renal Cell Carcinoma

2020 ◽  
Vol 14 (2) ◽  
pp. 98-104
Author(s):  
Alessio Cortellini ◽  
Sebastiano Buti ◽  
Melissa Bersanelli ◽  
Katia Cannita ◽  
Giada Pinterpe ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Multivariate Analysis ◽  
High Risk ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Disease Free Survival ◽  
Free Survival ◽  
Risk Of Recurrence ◽  
Significant Difference ◽  
Disease Free

Background: Recently, the GRANT (GRade, Age, Nodes, and Tumor) score was validated through an adjuvant trial population. Methods: This retrospective study evaluated the performance of the GRANT score as a prognostic model for disease-free survival (DFS), compared to the University of California Los Angeles Integrated Staging System (UISS) score, in a “real-life” population of early renal cell carcinoma patients. A uni-/multivariate analysis of DFS was also performed, to weigh the roles of baseline clinical factors. Results: From February 1998 to January 2018, 134 consecutive patients were enrolled, of which 85 patients (63.4%) had a favorable GRANT score, 49 (36.6%) an unfavorable GRANT score, and 21 (15.7%), 84 (62.6%), and 29 (21.6%) patients had a low, intermediate, or high risk of recurrence according to the UISS score, respectively. The median follow-up was 96 months. The median DFS of the overall study population was 53.7 months (95% CI: 38.4-87.8). Only bilateral renal cell carcinoma (p = 0.0041), Fuhrman grade 3/4 (p = 0.0008), pT3b- 4 (p = 0.0324), and pN1-2 (p = 0.0303) pathological status were confirmed as independent predictors of a shorter DFS by the multivariate analysis. The median DFS of patients with favorable and unfavorable GRANT scores were 84.9 (95% CI: 49.8-129) and 38.4 months (95% CI: 24.4-87.8), respectively, with a statistically significant difference (p = 0.0147). The median DFS of patients with low, intermediate, and high risk of recurrence according to the UISS score were 92.3 (95% CI: 18.1-153.9), 51.7 (95% CI: 36.2-87.8), and 49.8 months (95% CI: 31.3-129), respectively, without statistically significant differences (p = 0.4728). DFS c-statistic values were 0.59 (95% CI: 0.51-0.67) and 0.51 (95% CI: 0.42-0.60) for the GRANT and the UISS scores, respectively. Conclusion: The GRANT score might be a useful tool that is user-friendly and easy to perform in clinical practice.

Effect of salvage radiofrequency ablation on local control of recurrent renal cell carcinoma.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 355-355
Author(s):  
S. P. Psutka ◽  
A. Daha ◽  
D. Gervais ◽  
A. S. Feldman
Keyword(s):  
Renal Cell Carcinoma ◽  
Radiofrequency Ablation ◽  
Cell Carcinoma ◽  
Local Control ◽  
Renal Cell ◽  
Recurrent Disease ◽  
Complete Response ◽  
Disease Recurrence ◽  
Disease Free

355 Background: Radiofrequency ablation (RFA) has emerged as a safe and efficacious option to manage small renal cell carcinoma (RCC) in patients for whom comorbidities preclude surgical treatment. Salvage surgical excision of disease recurrence after ablative therapy is often complicated by extensive perinephric fibrosis. There are no reports in the literature which assess salvage RFA (sRFA) of recurrent disease (RD). The aim of this study was to assess the overall efficacy, complications, and safety of sRFA. Methods: Between 1998 and 2008, 313 patients underwent RFA for RCC. RD was defined as detectable new enhancing tissue in the prior RFA-cavitation site after a documented complete response. We retrospectively compared patients who developed RD (RD+, n = 15, 5.1%) with patients who remained disease free after a complete response (RD−, n = 296, 95%), assessing tumor characteristics (size, location, biopsy pathology), complications, and disease-free survival. Mean follow-up was 3 years (SD 2.1). Results: RD+ and RD− groups did not differ significantly in age, gender, or tumor type. In tumors < 4cm, 3.3% were RD+. In tumors >= 4cm, 9.6% were RD+ (p<0.0001). RD+ groups were more likely to have central tumors (20% vs. 5.7%, p = 0.04). Mean time to disease recurrence was 1.47 years (SD 0.75, 0.5-3.5 yrs). Of the 15 patients with RD, 7 patients underwent sRFA, 6 patients elected observation due to comorbidities precluding further treatment, one patient received chemotherapy for widespread metastases and one patient underwent salvage partial nephrectomy, which was aborted due to extensive tumor burden and perirenal fibrosis. There were no complications related to sRFA. Of those who underwent sRFA, local recurrences were successfully ablated in 100% of cases with a single salvage RFA treatment. None of these sRFA cases developed locally recurrent disease at an average of 3 years follow-up. Conclusions: RD after RFA remains challenging to treat due to the significant comorbidities of the patients who are candidates for ablative treatment of RCC. RD was more likely to occur in centrally located tumors, > 4cm in size. Salvage RFA successfully can achieve local control in these patients without increased rates of complications. No significant financial relationships to disclose.

Randomized, double-blind phase III study of pazopanib versus placebo in patients with metastatic renal cell carcinoma who have no evidence of disease following metastasectomy: A trial of the ECOG-ACRIN cancer research group (E2810).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 4502-4502 ◽  
Author(s):  
Leonard Joseph Appleman ◽  
Maneka Puligandla ◽  
Sumanta K. Pal ◽  
Wayne Harris ◽  
Neeraj Agarwal ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Patient Reported Outcomes ◽  
Disease Free Survival ◽  
Double Blind ◽  
Free Survival ◽  
Patient Reported ◽  
Disease Free

4502 Background: Patients with no evidence of disease (NED) after metastasectomy for metastatic renal cell carcinoma (mRCC) are at high risk of recurrence, but no systemic therapy has been shown to benefit this population. Pazopanib is an inhibitor of VEGFR and other kinases that improves progression-free survival in patients with measurable RCC metastatic disease. We performed a randomized, double-blind, placebo-controlled multicenter study to test the hypothesis that pazopanib would improve disease-free survival in patients with mRCC rendered NED after metastasectomy Methods: Patients with NED following metastasectomy were randomized 1:1 to receive pazopanib starting at 800 mg daily vs. placebo for 52 weeks. Patients were stratified by 1 vs. > 1 site of resected disease, and by disease-free interval ≤ vs. > 1 year. Clinical assessment for toxicity and patient-reported outcomes were performed every 4 weeks, and restaging scans every 12 weeks. The study was designed to observe a 42% improvement in disease-free survival (DFS) from 25% to 45% at 3 years. Results: From August 2012 to July 2017, 129 patients were enrolled. The study was unblinded after 83 DFS events had been observed (92% information). The median follow-up from randomization was 30 months (range 0.4 – 66.5 months). The study did not meet the primary endpoint: hazard ratio (95% CI) for DFS was 0.85 (0.55, 1.31) p= 0.47 in favor of pazopanib. At the time of unblinding, 22/129 (17%) of subjects had died. The HR for overall survival (OS) was 2.65 (1.02, 6.9) in favor of placebo ( p= 0.05). Patient-reported outcomes and laboratory correlates will be reported separately. Conclusions: 52 weeks of pazopanib did not improve DFS compared to blinded placebo in patients with mRCC who were NED after metastasectomy. There was a trend toward worse overall survival with pazopanib. Clinical trial information: NCT01575548.

scholarly journals Conditional disease-free survival in high-risk renal cell carcinoma treated with sunitinib

Aging ◽  
2019 ◽  
Vol 11 (23) ◽  
pp. 11490-11503
Author(s):  
Ning Shao ◽  
Hengchuan Su ◽  
Dingwei Ye
Keyword(s):  
Renal Cell Carcinoma ◽  
High Risk ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free
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