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Bodard S, Boudhabhay I, Dariane C, Delavaud C, Guinebert S, Joly D, Timsit MO, Mejean A, Verkarre V, Hélénon O, Richard S, Correas JM. Percutaneous Thermal Ablation for Renal Tumors in Patients with Birt–Hogg–Dubé Syndrome. Cancers (Basel) 2022; 14:cancers14204969. [PMID: 36291753 PMCID: PMC9599652 DOI: 10.3390/cancers14204969] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/03/2022] [Accepted: 10/07/2022] [Indexed: 11/16/2022] Open
Abstract
BHD syndrome is characterized by an increased risk of bilateral and multifocal renal cell carcinoma (RCCs), but is rarely metastatic. Our report aims to analyze the outcome of patients with BHD syndrome who underwent percutaneous thermal ablation (TA). The present report included six BHD syndrome patients (five men) with a mean age of 66 ± 11 (SD) years who had a proven germline FLCN gene mutation and underwent TA for a renal tumor. Nineteen renal tumors (median two tumors per patient; range: 1–3), including seven chromophobe RCCs, five clear-cell RCCs, four papillary RCCs, two clear-cell papillary RCC, and one hybrid oncocytic/chromophobe tumor were treated in 14 ablation sessions. The mean size of the tumors was 21 ± 11 (SD) mm (median: 20 mm; interquartile range (IQR): 14–25 mm) for a mean volume of 7 ± 11 (SD) mL (median: 3; IQR: 1–5 mL). Technical success was achieved in all ablation sessions (primary success rate, 100%). The procedure was well tolerated under conscious sedation with no significant Clavien–Dindo complication (grade 2, 3, 4). All patients were alive with no distant metastasis during a median follow-up period of 74 months (range: 33–83 months). No local tumor progression was observed. The mean decrease in estimated glomerular filtration rate was 8 mL/min/1.73 m2. No patients required dialysis or renal transplantation. In this case series, percutaneous TA appeared as a safe and efficient nephron-sparing treatment for treating RCCs associated with BHD syndrome, even in the case of advanced chronic kidney disease.
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Affiliation(s)
- Sylvain Bodard
- AP-HP, Hôpital Necker Enfants Malades, Service d’Imagerie Adulte, F-75015 Paris, France
- Université de Paris Cité, F-75006 Paris, France
- Sorbonne Université, CNRS, INSERM Laboratoire d’Imagerie Biomédicale, F-75005 Paris, France
- Correspondence: ; Tel.: +33-618816210
| | - Idris Boudhabhay
- Université de Paris Cité, F-75006 Paris, France
- AP-HP, Hôpital Necker Enfants Malades, Service de Néphrologie–Transplantation Adulte, F-75015 Paris, France
| | - Charles Dariane
- Université de Paris Cité, F-75006 Paris, France
- AP-HP, Hôpital Européen Georges Pompidou, Service d’Urologie, F-75015 Paris, France
| | - Christophe Delavaud
- AP-HP, Hôpital Necker Enfants Malades, Service d’Imagerie Adulte, F-75015 Paris, France
| | - Sylvain Guinebert
- AP-HP, Hôpital Necker Enfants Malades, Service d’Imagerie Adulte, F-75015 Paris, France
- Université de Paris Cité, F-75006 Paris, France
| | - Dominique Joly
- Université de Paris Cité, F-75006 Paris, France
- AP-HP, Hôpital Necker Enfants Malades, Service de Néphrologie–Transplantation Adulte, F-75015 Paris, France
| | - Marc-Olivier Timsit
- Université de Paris Cité, F-75006 Paris, France
- AP-HP, Hôpital Necker Enfants Malades, Service de Néphrologie–Transplantation Adulte, F-75015 Paris, France
- Réseau National pour Cancers Rares de l’Adulte PREDIR labellisé par l’INCa/AP-HP, Hôpital Bicêtre, F-94270 Le Kremlin-Bicêtre, France
| | - Arnaud Mejean
- Université de Paris Cité, F-75006 Paris, France
- AP-HP, Hôpital Européen Georges Pompidou, Service d’Urologie, F-75015 Paris, France
- Réseau National pour Cancers Rares de l’Adulte PREDIR labellisé par l’INCa/AP-HP, Hôpital Bicêtre, F-94270 Le Kremlin-Bicêtre, France
| | - Virginie Verkarre
- Université de Paris Cité, F-75006 Paris, France
- Réseau National pour Cancers Rares de l’Adulte PREDIR labellisé par l’INCa/AP-HP, Hôpital Bicêtre, F-94270 Le Kremlin-Bicêtre, France
- AP-HP, Hôpital Européen Georges Pompidou, Service d’Anatomie et Cytologie Pathologiques, F-75015 Paris, France
| | - Olivier Hélénon
- AP-HP, Hôpital Necker Enfants Malades, Service d’Imagerie Adulte, F-75015 Paris, France
- Université de Paris Cité, F-75006 Paris, France
| | - Stéphane Richard
- Réseau National pour Cancers Rares de l’Adulte PREDIR labellisé par l’INCa/AP-HP, Hôpital Bicêtre, F-94270 Le Kremlin-Bicêtre, France
- Ecole Pratique des Hautes Etudes, EPHE, Université PSL, F-75014, France
- UMR 9019-CNRS, Gustave Roussy Cancer Campus, F-94800 Villejuif, France
- Service d’Urologie, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, F-94270 Le Kremlin-Bicêtre, France
| | - Jean-Michel Correas
- AP-HP, Hôpital Necker Enfants Malades, Service d’Imagerie Adulte, F-75015 Paris, France
- Université de Paris Cité, F-75006 Paris, France
- Sorbonne Université, CNRS, INSERM Laboratoire d’Imagerie Biomédicale, F-75005 Paris, France
- Réseau National pour Cancers Rares de l’Adulte PREDIR labellisé par l’INCa/AP-HP, Hôpital Bicêtre, F-94270 Le Kremlin-Bicêtre, France
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