Systematic review of ablative therapy for the treatment of renal allograft neoplasms

Table 1 Characteristics of studies meeting the criteria for the systematic review

Study	Design	Period	Total	Ablation	Ablation	Quality
			sample size	sample size	technique
			(P/N)	(P/N)
Charboneau et al[18]	R-CR	2002	1/1	1/1	RF	L
Shingleton et al[17]	R-CR	2002	1/1	1/1	CA	L
Baughman et al[19]	R-CR	2004	1/1	1/1	RF	L
Hruby et al[22]	R-CR	2006	1/1	1/1	CA	L
Goeman et al[21]	R-CR	2006	1/1	1/1	RF	L
Aron et al[23]	R-CR	2007	1/1	1/1	RF	L
Matevossian et al[24]	R-CR	2008	1/1	1/1	RF	L
Sanchez et al[26]	R-CR	2009	1/1	1/1	RF	L
Chakera A et al[27]	R-CR	2010	1/1	1/1	HIFU	L
Olivani et al[29]	R-CR	2011	1/1	1/1	RF	L
Silvestri et al[36]	R-CR	2014	1/1	1/1	CA	L
Christensen et al[38]	R-CR	2015	1/1	1/1	RF	L
Roy et al[20]	S-U-R-CS	2005	2/2	1/1	RF	L
Veltri et al[25]	S-U-R-CS	2009	3/3	3/3	RF	L
Elkentaoui et al[28]	S-U-R-CS	2010	39/42	2/2	RF	L
Leveridge et al[31]	S-U-R-CS	2011	47/53	3/3	RF	L
Ploussard et al[32]	S-U-R-CS	2012	12/17	2/2	CA	L
Swords et al[34]	S-U-R-CS	2013	4/4	1/1	RF	L
Vegso et al[35]	S-U-R-CS	2013	9/9	5/5	RF	L
Su et al[37]	S-U-R-CS	2014	4/5	1/2	RF	L
Hernàndez et al[39]	S-U-R-CS	2015	4/4	1/1	RF	L
Cool et al[41]	S-U-R-CS	2017	10/12	10/12	RF	A
Iezzi et al[42]	S-U-R-CS	2018	3/3	3/3	RF	L
Di Candio et al[43]	S-U-R-CS	2019	3/4	3/4	RF, HIFU	L
Gul et al[44]	S-U-R-CS	2019	6/6	6/6	CA, MW, IRE	L
Tillou et al[33]	M-U-R-CS	2012	79/79	5/5	RF	A
Cornelis et al[30]	M-U-R-CS	2011	20/24	20/24	RF, CA	A
Guleryuz et al[40]	M-C-R-CS	2016	92/92	14/14	RF, CA	H

P: Patient; N: Neoplasm; R: Retrospective; CR: Case report; RF: Radiofrequency ablation; L: Low; CA: Cryoablation; HIFU: High-intensity focused ultrasound; S: Single-centre; U: Uncontrolled; CS: Case series; A: Average; MW: Microwave ablation; IRE: Irreversible electroporation; M: Multi-centre; C: Controlled; H: High.

Table 2 Summary of the characteristics of the case reports and the case series of kidney allograft neoplasms treated by ablative therapy¹

Variables	Range or number
Neoplasms	100
Imaging-based diagnosis
RCC	94
Cystic mass	4
Oncocytoma	1
Not available	1
Localization
Interpolar	16
Lower pole	12
Upper pole	10
Not available	62
Growth pattern
Endophytic	27
Exophytic	16
Mixed exo-endophytic	5
Not available	52
Size
Maximal diameter (mm)	5-55
Maximal diameter 0-20 mm	37
Maximal diameter 21-30 mm	26
Maximal diameter 31-40 mm	9
Maximal diameter > 40 mm	1
Not available	27
Histology-based diagnosis
Papillary RCC	48
Clear cell RCC	20
Chromophobe RCC	2
Tubulo-papillary RCC	2
Tubulo-cystic RCC	1
Mixed clear cell and papillary RCC	1
RCC not otherwise specified	17
Oncocytoma	1
Indeterminate	1
Not available	7
Fuhrman grading score
Grade I	10
Grade II	24
Grade I-II	3
Grade III	1
Not available	62
AJCC TNM classification
T1a N0 M0	91
T1b N0 M0	2
Not available	7
Ablative treatment
RFA	78
CA	15
MWA	3
HIFU	3)
IRE	1/100 (1)

¹Summaries based on individual cases should not be considered as an estimate of the “real world”. RCC: Renal cell carcinoma; AJCC: American Joint Committee on Cancer; TNM: Tumor nodes metastasis; RFA: Radiofrequency ablation; CA: Cryoablation; MWA: Microwave ablation; HIFU: High-intensity focused ultrasound; IRE: Irreversible electroporation.

Table 3 Summary of the overall outcomes of ablative therapy of kidney allograft neoplasms from the case reports and the case series examined¹

Variables	Range or number
Procedures	100
Patients	92
Interventional access
Percutaneous	81
Open	1
Laparoscopic	1
Transosseous	1
Not available	16
Guidance modality
US	31
CT	20
MRI	1
US and CT	19
Not available	29
Primary treatment failure	3
Secondary treatment failure	1
Recurrence	1
Disease-specific mortality	0
Overall renal allograft loss	5
Peri-operative complication	11
Urinary leakage	1
Post-infarction syndrome	1
Hematoma	2
Infection of the ablation site	2
Leg pain due to nerve injury	4
Leg pain due to muscle injury	1
Follow-up (mo)	1-81

¹Summaries based on individual cases should not be considered as an estimate of the “real world”. US: Ultrasound; CT: Computed tomography; MRI: Magnetic resonance imaging.

Table 4 Summary of the different ablative therapies described in the case reports and the case series examined¹

Variables	Range or Number
	RFA	CA	HIFU		MWA	IRE
Procedures	78	15	3		3	1
Patients	70	15	3		3	1
Tumor size (mm)	5-40	15-35	8-55		21-28	16
Tumor histology
Clear cell	10	7	1		1	1
Papillary	41	3	2		2	0
Mixed RCC	0	1	0		0	0
Chromophobe	2	0	0		0	0
Tubulo-papillary	2	0	0		0	0
Tubulo-cystic	1	0	0		0	0
RCC NOS	17	0	0		0	0
Oncocytoma	0	1	0		0	0
Indeterminate	0	1	0		0	0
Not available	5	2	0		0	0
Interventional access
Percutaneous	67	8	3		2	1
Open	0	1	0		0	0
Laparoscopic	0	1	0		0	0
Transosseous	0	0	0		1	0
Not available	11	5	0		0	0
Guidance modality
US	24	4	3		0	0
CT	12	4	0		3	1
MRI	0	1	0		0	0
US and CT	18	1	0		0	0
Not available	24	5	0		0	0
Primary treatment failure	2	0	1		0	0
Re-treatment failure	0	-	1		-	-
Recurrence	1	0	0		0	0
Disease-specific mortality	0	0	0		0	0
Renal allograft loss	5	0	0		0	0
Complications	8	2	0		1	0
Follow-up (mo)	3-71	1-59	12-81		8-61	34

¹Summaries based on individual cases should not be considered as an estimate of the “real world”. RCC: Renal cell carcinoma; NOS: Not otherwise specified; US: Ultrasound; CT: Computed tomography; MRI: Magnetic resonance imaging.