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IMPROVED RECURRENCE-FREE SURVIVAL FOLLOWING IMPLEMENTATION OF A 3D TUMOR MODEL FUSION PIPELINE FOR RENAL MASS ABLATION
Raymond Che, MPH1, Richard Glebocki, ScB
1, Aaron Seto, ScB, AB
1, Borivoj Golijanin, MD
1, Brian Jay, MD
2, Kamil Malshy, MD
1, Emily Barry, MD
1, Scott Collins, RT(R)(CT)
2, Aaron Maxwell, MD
2, Gregory Dubel, MD
2, Sari Khaleel, MD
1, Dragan Golijanin, MD
1.
1The Minimally Invasive Urology Institute at the Miriam Hospital, Brown University Health, Legoretta Cancer Center, Warren Alpert Medical School of Brown University, Providence, RI, USA,
2Brown University Health, Warren Alpert Medical School of Brown University, Providence, RI, USA.
INTRODUCTION: Renal mass ablations (RMAs) are a non-surgical, nephron-sparing approach for treating renal masses in patients with significant comorbidities. Our team developed a radiomics-driven 3D tumor modeling and fusion pipeline for pre-procedure planning. This study evaluates differences in recurrence-free survival (RFS) and overall survival (OS) in patients who underwent RMA for primary renal lesions, stratified by pipeline use.
METHODS: We conducted a retrospective review of RMA patients between 2014 to 2023. Kaplan-Meier analysis and Cox regression were used to estimate survival probabilities and hazard ratios (HRs) for RFS and OS.
RESULTS: Our cohort consisted of 523 patients who underwent RMA for primary renal masses. Pre-procedure 3D modeling was performed on 331 patients (63.29% of cases) and was associated with a reduced risk of recurrence (HR 0.48, 95% CI: 0.30-0.78, p=0.003, Figure 1A). Similar findings were observed among the 290 patients with biopsy-confirmed malignant renal lesions, with a RFS HR of 0.49 (95% CI: 0.27-0.90, p=0.021, Figure 1B). No significant differences in OS were noted among all patients (HR 0.79, 95% CI: 0.50-1.25, p=0.318, Figure 1C) or those with malignant lesions (HR 0.62, 95% CI: 0.34-1.14, p=0.127, Figure 1D). RFS rates with 3D modeling among all patients were 99% at 6 months, 97% at 12 months, 90% at 36 months, and 85% at 60 months.
CONCLUSIONS: Our results support improved RFS among patients undergoing renal mass ablation following the implementation of a 3D tumor model fusion pipeline, with no impact on OS. Future directions include evaluating how 3D modeling correlates with functional outcomes, such as post-ablation renal function.
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