Ospedale San Raffaele Sede di Ville Turro - UOC Radiology, Milan, Italy.
Ospedale San Raffaele Sede di Ville Turro - UOC Urology, Milan, Italy.
Med Oncol. 2020 Mar 12;37(4):26. doi: 10.1007/s12032-020-01351-3.
RENAL score has been validated on predicting adverse events and relapses in percutaneous treatments of renal lesions. To better fit interventional issues a modified score (mRENAL) has been introduced, but the only difference from the RENAL score is on the dimensional parameter. However, it remains of surgical derivation while a specific interventional score is missing. This study aims to obtain a specific score (ABLATE) to better quantify the risk of complications and relapses in percutaneous kidney ablation procedures compared to the existing surgical scores. Taking inspiration from previous papers, a score was built to quantify the real difficulties faced in percutaneous treatment of renal lesions. The ABLATE score was used on 71 cryoablations to evaluate its predictivity of complications and relapses. Logistic regression was used to predict complication incidence; Cox-regression was used for relapses; ROC analysis was used to evaluate the accuracy of the different scores. Between January 2014 and November 2019, 71 lesions in 68 patients were treated. Overall, malignant histology was found in 62 lesions (87.3%). Mean and median RENAL, mRENAL, and ABLATE scores were 7.04 and 7, 7.19 and 7, and 5.11 and 4, respectively. Out of 71 treatments, we experienced 3 bleeding with anemia (4.2%), only 2 of which needed further treatment (2.82%). The mean and median RENAL, mRENAL, and ABLATE scores in those with complications were 7.66 and 7.01 (p = 0.69), 8.0 and 7.1 (p = 0.54), and 6.6 and 5.0 (p = 0.38), respectively. Out of 62 malignant lesions, we experienced 2 persistent and 6 recurrent lesions (3.2% and 8.4%, respectively). At Cox-regression analyses, mABLATE score outperformed both RENAL and mRENAL scores in predicting recurrences (HR 1.48; p < 0.001 vs. 1.41; p = 0.1 vs. 1.38: p = 0.07, respectively). The ABLATE score showed to be a better predictor of relapses than RENAL and mRENAL. The small number of complications conditioned a lack of statistic power on complications for all the scores. At the moment to quantify the risks in percutaneous kidney ablation procedures, surgical scores are used. A specific score better performs this task.
肾脏评分已被验证可用于预测经皮肾病变治疗的不良事件和复发。为了更好地适应介入问题，引入了改良评分（mRENAL），但与肾脏评分的唯一区别在于维度参数。然而，它仍然是手术衍生的，而缺乏特定的介入评分。本研究旨在获得一种特定的评分（ABLATE），以更好地量化经皮肾消融术治疗中并发症和复发的风险，与现有的手术评分相比。本研究从之前的论文中获得灵感，建立了一个评分来量化经皮治疗肾病变中面临的实际困难。ABLATE 评分用于 71 例冷冻消融术，以评估其对并发症和复发的预测能力。使用逻辑回归预测并发症发生率；使用 Cox 回归预测复发；ROC 分析用于评估不同评分的准确性。2014 年 1 月至 2019 年 11 月，对 68 例患者的 71 个病灶进行了治疗。总体而言，62 个病灶（87.3%）发现恶性组织学。平均和中位数 RENAL、mRENAL 和 ABLATE 评分为 7.04 和 7、7.19 和 7、5.11 和 4。在 71 例治疗中，我们经历了 3 例贫血性出血（4.2%），其中仅 2 例需要进一步治疗（2.82%）。有并发症的患者的平均和中位数 RENAL、mRENAL 和 ABLATE 评分分别为 7.66 和 7.01（p=0.69）、8.0 和 7.1（p=0.54）和 6.6 和 5.0（p=0.38）。在 62 个恶性病灶中，我们经历了 2 个持续性和 6 个复发性病灶（分别为 3.2%和 8.4%）。在 Cox 回归分析中，mABLATE 评分在预测复发方面优于 RENAL 和 mRENAL 评分（HR 1.48；p<0.001 与 1.41；p=0.1 与 1.38：p=0.07）。ABLATE 评分在预测复发方面优于 RENAL 和 mRENAL。并发症数量较少，导致所有评分在统计并发症方面的效能不足。目前，在量化经皮肾消融术的风险时，使用的是手术评分。一个特定的评分可以更好地完成这项任务。
