Login to Access Video or Poster Abstract: MP100-11
Sources of Funding: none

Introduction

Percutaneous irreversible electroporation (IRE) is a novel minimally invasive technique to treat small renal tumors. IRE uses an electric field to create nano-pores within cellular membranes resulting in subsequent apoptosis. Because IRE is athermal, it offers potential advantages to radiofrequency (RFA) and cryoablation. We report on the longest followup outcomes of IRE renal tumor ablation.

Methods

We retrospectively reviewed all IRE cases completed at our institution from April 2013-June 2016. IRE was performed using the NanoKnife® commercial system and 15 cm monopolar probes (AngioDynamics, NY, USA). All procedures were performed with computed tomography (CT) guidance, under general anesthesia with paralytics, and with ablation synchronized to the cardiac cycle. A minimum of three months of follow-up with a contrast-enhanced CT scan was necessary to be included in the analysis.

Results

A total of 39 tumors in 38 patients underwent irreversible electroporation. Mean tumor size was 2.0 cm with a median R.E.N.A.L nephrometry score of 5. Twenty-six patients (68%) were discharged the same day of the procedure and no major (Clavien grade III or higher) intraoperative or post-operative complications occurred. Initial treatment success rate was 92%; our three failures (8%) underwent salvage radiofrequency ablation. With a median follow-up of 25.2 months, two-year local recurrence-free survival was 76% for patients with biopsy confirmed renal cell carcinoma, 84% with biopsy confirmed or a history of renal cell carcinoma, and 90% for the intent-to-treat cohort (figure 1).

Conclusions

Percutaneous irreversible electroporation has suboptimal short-term local disease control results compared to thermal ablation in this series of small, low complexity tumors. Larger series and longer follow-up is still needed to determine the durability of this modality for renal cell carcinoma.

Funding

none