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• W2914836488 abstract "No AccessJournal of UrologyAdult Urology1 Jun 2019Stereotactic Radiotherapy as a Treatment Option for Renal Tumors in the Solitary Kidney: A Multicenter Analysis from the IROCKThis article is commented on by the following:Editorial Comment Rohann J. M. Correa, Alexander V. Louie, Michael Staehler, Andrew Warner, Senthilkumar Gandhidasan, Lee Ponsky, Rodney Ellis, Irving Kaplan, Anand Mahadevan, William Chu, Anand Swaminath, Hiroshi Onishi, Bin S. Teh, Simon S. Lo, Alexander Muacevic, and Shankar Siva Rohann J. M. CorreaRohann J. M. Correa Departments of Radiation Oncology, London Regional Cancer Program, London, Ontario, Canada Equal study contribution. More articles by this author , Alexander V. LouieAlexander V. Louie Departments of Radiation Oncology, London Regional Cancer Program, London, Ontario, Canada Equal study contribution. More articles by this author , Michael StaehlerMichael Staehler University of Munich Hospitals, Munich, Germany More articles by this author , Andrew WarnerAndrew Warner Departments of Radiation Oncology, London Regional Cancer Program, London, Ontario, Canada More articles by this author , Senthilkumar GandhidasanSenthilkumar Gandhidasan Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Australia More articles by this author , Lee PonskyLee Ponsky University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Cleveland, Ohio More articles by this author , Rodney EllisRodney Ellis University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Cleveland, Ohio More articles by this author , Irving KaplanIrving Kaplan Beth Israel Deaconess Medical Center, Boston, Massachusetts More articles by this author , Anand MahadevanAnand Mahadevan University of Munich Hospitals, Munich, Germany Geisinger Health, Danville, Pennsylvania More articles by this author , William ChuWilliam Chu Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada More articles by this author , Anand SwaminathAnand Swaminath Division of Radiation Oncology, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada More articles by this author , Hiroshi OnishiHiroshi Onishi Department of Radiology, University of Yamanashi, Yamanashi, Japan More articles by this author , Bin S. TehBin S. Teh Department of Radiation Oncology, Houston Methodist Hospital, Cancer Center and Research Institute, Houston, Texas More articles by this author , Simon S. LoSimon S. Lo Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington More articles by this author , Alexander MuacevicAlexander Muacevic More articles by this author , and Shankar SivaShankar Siva †Correspondence: Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Center, 305 Grattan St., Melbourne, Victoria , Australia (telephone: +61 3 8559 5000; e-mail: E-mail Address: [email protected]). Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Australia More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000111AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Stereotactic ablative radiotherapy is an emerging treatment for renal cell carcinoma. Our study objective was to evaluate this therapy in patients with a solitary kidney, focusing on oncologic and renal function outcomes. Materials and Methods: We pooled individual patient data from 9 IROCK (International Radiosurgery Oncology Consortium for Kidney) institutions in Germany, Australia, the United States of America, Canada and Japan. Median followup was 2.6 years. Baseline characteristics and outcomes were compared between the solitary and bilateral kidney cohorts. Predictors of renal function after stereotactic ablative radiotherapy were assessed by logistic regression modeling. Results: A total of 81 patients with a solitary kidney underwent stereotactic ablative radiotherapy. Mean age was 67.3 years and 97.5% of patients had good performance status, including ECOG (Eastern Cooperative Oncology Group) 0-1 or KPS (Karnofsky Performance Status) 70% or greater. Median tumor diameter was 3.7 cm (IQR 2.5–4.3) and 37% of tumors were 4 cm or greater. The 138 patients in the bilateral cohort harbored larger tumors and were older (p <0.001) with a lower baseline estimated glomerular filtration rate (p = 0.024). After stereotactic ablative radiotherapy in the solitary kidney cohort the mean ± SD estimated glomerular filtration rate decrease was –5.8 ± 10.8 ml per minute (–9%). No patient with a solitary kidney required dialysis. After stereotactic ablative radiotherapy a tumor size of 4 cm or greater was associated with an estimated glomerular filtration rate decrease of 15 ml per minute or greater (OR 4.2, p = 0.029). At 2 years the rates of local control, and progression-free, cancer specific and overall survival in the solitary cohort were 98.0%, 77.5%, 98.2% and 81.5%, respectively. There was no significant difference in renal function or oncologic outcomes between the cohorts (p >0.05). Conclusions: In this analysis of the IROCK database stereotactic ablative radiotherapy in patients with a solitary kidney had an acceptable impact on renal function and achieved excellent oncologic outcomes, similar to those in patients with bilateral kidneys. Thus, stereotactic ablative radiotherapy represents a viable treatment option in patients with renal cell carcinoma in a solitary kidney. 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Google Scholar 30. : Comparison of partial nephrectomy and percutaneous ablation for cT1 renal masses. Eur Urol 2015; 67: 252. Google Scholar The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. © 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited bySmith J (2019) This Month in Adult UrologyJournal of Urology, VOL. 201, NO. 6, (1025-1026), Online publication date: 1-Jun-2019.Related articlesJournal of Urology28 Mar 2019Editorial Comment Volume 201Issue 6June 2019Page: 1097-1104Supplementary Materials Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.Keywordsradiosurgerycarcinomastereotaxic techniquesrenal cellradiofrequency ablationsolitary kidneyMetricsAuthor Information Rohann J. M. Correa Departments of Radiation Oncology, London Regional Cancer Program, London, Ontario, Canada Equal study contribution. More articles by this author Alexander V. Louie Departments of Radiation Oncology, London Regional Cancer Program, London, Ontario, Canada Equal study contribution. More articles by this author Michael Staehler University of Munich Hospitals, Munich, Germany More articles by this author Andrew Warner Departments of Radiation Oncology, London Regional Cancer Program, London, Ontario, Canada More articles by this author Senthilkumar Gandhidasan Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Australia More articles by this author Lee Ponsky University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Cleveland, Ohio More articles by this author Rodney Ellis University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Cleveland, Ohio More articles by this author Irving Kaplan Beth Israel Deaconess Medical Center, Boston, Massachusetts More articles by this author Anand Mahadevan University of Munich Hospitals, Munich, Germany Geisinger Health, Danville, Pennsylvania More articles by this author William Chu Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada More articles by this author Anand Swaminath Division of Radiation Oncology, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada More articles by this author Hiroshi Onishi Department of Radiology, University of Yamanashi, Yamanashi, Japan More articles by this author Bin S. Teh Department of Radiation Oncology, Houston Methodist Hospital, Cancer Center and Research Institute, Houston, Texas More articles by this author Simon S. Lo Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington More articles by this author Alexander Muacevic More articles by this author Shankar Siva Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Australia †Correspondence: Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Center, 305 Grattan St., Melbourne, Victoria , Australia (telephone: +61 3 8559 5000; e-mail: E-mail Address: [email protected]). More articles by this author Expand All The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Advertisement PDF downloadLoading ..." @default.
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