Volumetric and functional outcomes at 1-year between percutaneous-ablation and partial-nephrectomy for T1b renal tumors
Copyright © 2023 Elsevier Masson SAS. All rights reserved..
INTRODUCTION: Indication for percutaneous-ablation (PA) is gradually expanding to renal tumors T1b (4-7cm). Few data exist on the alteration of renal functional volume (RFV) post-PA. Yet, it is a surrogate marker of post partial-nephrectomy (PN) glomerular filtration rate (GFR) impairment. The objective was to compare RFV and GFR at 1-year post-PN or PA, in this T1b population.
METHODS: Patients with unifocal renal tumor≥4cm treated between 2014 and 2019 were included. Tumor, homolateral (RFVh), contralateral RFV, and total volumes were assessed by manual segmentation (3D Slicer) before and at 1 year of treatment, as was GFR. The loss of RFV, contralateral hypertrophy, and preservation of GFR were compared between both groups (PN vs. PA).
RESULTS: 144 patients were included (87PN, 57PA). Preoperatively, PA group was older (74 vs. 59 years; P<0.0001), had more impaired GFR (73 vs. 85mL/min; P=0.0026) and smaller tumor volume(31.1 vs. 55.9cm3; P=0.0007) compared to PN group. At 1 year, the PN group had significantly more homolateral RFV loss (-19 vs. -14%; P=0.002), and contralateral compensatory hypertrophy (+4% vs. +1,8%; P=0.02, respectively). Total-RFV loss was similar between both (-21.7 vs. -19cm3; P=0.07). GFR preservation was better in the PN group (95.9 vs. 90.7%; P=0.03). In multivariate analysis, age and tumor size were associated with loss of RFVh.
CONCLUSION: For renal tumors T1b, PN is associated with superior compensatory hypertrophy compared with PA, compensating for the higher RFVh loss, resulting in similar ΔRFV-total between both groups. The superior post-PN GFR preservation suggests that the preserved quantitative RFV factor is insufficient. Therefore, the underlying quality of the parenchyma would play a major role in postoperative GFR.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:33 |
|---|---|
| Enthalten in: |
Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie - 33(2023), 10 vom: 04. Sept., Seite 509-518 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Fourniol, C [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
3D segmentation |
|---|
| Anmerkungen: |
Date Completed 18.09.2023 Date Revised 18.09.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.purol.2023.08.019 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM361318979 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM361318979 | ||
| 003 | DE-627 | ||
| 005 | 20231226084904.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.purol.2023.08.019 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1204.xml |
| 035 | |a (DE-627)NLM361318979 | ||
| 035 | |a (NLM)37633733 | ||
| 035 | |a (PII)S1166-7087(23)00168-9 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Fourniol, C |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Volumetric and functional outcomes at 1-year between percutaneous-ablation and partial-nephrectomy for T1b renal tumors |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 18.09.2023 | ||
| 500 | |a Date Revised 18.09.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Masson SAS. All rights reserved. | ||
| 520 | |a INTRODUCTION: Indication for percutaneous-ablation (PA) is gradually expanding to renal tumors T1b (4-7cm). Few data exist on the alteration of renal functional volume (RFV) post-PA. Yet, it is a surrogate marker of post partial-nephrectomy (PN) glomerular filtration rate (GFR) impairment. The objective was to compare RFV and GFR at 1-year post-PN or PA, in this T1b population | ||
| 520 | |a METHODS: Patients with unifocal renal tumor≥4cm treated between 2014 and 2019 were included. Tumor, homolateral (RFVh), contralateral RFV, and total volumes were assessed by manual segmentation (3D Slicer) before and at 1 year of treatment, as was GFR. The loss of RFV, contralateral hypertrophy, and preservation of GFR were compared between both groups (PN vs. PA) | ||
| 520 | |a RESULTS: 144 patients were included (87PN, 57PA). Preoperatively, PA group was older (74 vs. 59 years; P<0.0001), had more impaired GFR (73 vs. 85mL/min; P=0.0026) and smaller tumor volume(31.1 vs. 55.9cm3; P=0.0007) compared to PN group. At 1 year, the PN group had significantly more homolateral RFV loss (-19 vs. -14%; P=0.002), and contralateral compensatory hypertrophy (+4% vs. +1,8%; P=0.02, respectively). Total-RFV loss was similar between both (-21.7 vs. -19cm3; P=0.07). GFR preservation was better in the PN group (95.9 vs. 90.7%; P=0.03). In multivariate analysis, age and tumor size were associated with loss of RFVh | ||
| 520 | |a CONCLUSION: For renal tumors T1b, PN is associated with superior compensatory hypertrophy compared with PA, compensating for the higher RFVh loss, resulting in similar ΔRFV-total between both groups. The superior post-PN GFR preservation suggests that the preserved quantitative RFV factor is insufficient. Therefore, the underlying quality of the parenchyma would play a major role in postoperative GFR | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a 3D segmentation | |
| 650 | 4 | |a Néphrectomie partielle | |
| 650 | 4 | |a Partial-nephrectomy | |
| 650 | 4 | |a Percutaneous-ablation | |
| 650 | 4 | |a Renal cell carcinoma | |
| 650 | 4 | |a Segmentation 3D | |
| 650 | 4 | |a Traitement thermo-ablatif | |
| 650 | 4 | |a Tumeur du rein | |
| 650 | 4 | |a Volumetric | |
| 650 | 4 | |a Volumétrie | |
| 700 | 1 | |a Dariane, C |e verfasserin |4 aut | |
| 700 | 1 | |a Correas, J |e verfasserin |4 aut | |
| 700 | 1 | |a Audenet, F |e verfasserin |4 aut | |
| 700 | 1 | |a Pinar, U |e verfasserin |4 aut | |
| 700 | 1 | |a Anract, J |e verfasserin |4 aut | |
| 700 | 1 | |a Hostettler, A |e verfasserin |4 aut | |
| 700 | 1 | |a Panthier, F |e verfasserin |4 aut | |
| 700 | 1 | |a Timsit, M O |e verfasserin |4 aut | |
| 700 | 1 | |a Mejean, A |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie |d 1997 |g 33(2023), 10 vom: 04. Sept., Seite 509-518 |w (DE-627)NLM012649481 |x 1166-7087 |7 nnns |
| 773 | 1 | 8 | |g volume:33 |g year:2023 |g number:10 |g day:04 |g month:09 |g pages:509-518 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.purol.2023.08.019 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 33 |j 2023 |e 10 |b 04 |c 09 |h 509-518 | ||