Skip to main content
Top
Published in: CardioVascular and Interventional Radiology 2/2018

Open Access 01-02-2018 | Clinical Investigation

Incidence of Post-ablation Syndrome Following Image-Guided Percutaneous Cryoablation of Renal Cell Carcinoma: A Prospective Study

Authors: Jim Zhong, Janette Bambrook, Balbir Bhambra, Jonathan Smith, Jon Cartledge, Christy Ralph, Naveen Vasudev, Simon Whiteley, Tze Wah

Published in: CardioVascular and Interventional Radiology | Issue 2/2018

Login to get access

Abstract

Purpose

To prospectively evaluate the incidence of post-ablation syndrome (fever and flu-like symptoms) and impact on the quality of life in the first 10 days following percutaneous image-guided cryoablation for renal cell carcinoma (RCC).

Materials and Methods

A prospective study of all cryoablation procedures with biopsy proven RCC was conducted with institutional review board approval between 08/2012 and 04/2016. Sixty-four patients (43 males and 21 females) underwent cryoablation. Mean age was 68 (range 24–86). A telephone questionnaire survey was conducted on days 1, 3, 5, 7 and 10 following cryoablation, and complications were recorded. Data collected included temperature, degree of flu-like symptoms, severity of pain, percentage of pain relief with analgesics, interference with general activity and with work (graded on a 0–10 Numeric Intensity Scale).

Results

Following cryoablation, six patients (9%) out of 64 developed post-ablation syndrome. Thirty-three patients (52%) developed flu-like symptoms only, which completely resolved by day 10 in 25 patients (39%). One patient had pyrexia only, which was self- limiting by day 10. Twenty-four patients (38%) were asymptomatic. Pain (mean score = 2.1) and interference on general activities (mean score = 1.8) and work (mean score = 2) following cryoablation peaked on day 3 and improved subsequently. Forty-six patients (72%) had 90–100% pain relief by day 10. No major complications were observed.

Conclusion

The full spectrum of post-ablation syndrome following cryoablation occurs in approximately 9% of patients; however, 61% of patients experience flu-like symptoms in the first 10 days, which are self-limiting.
Literature
1.
go back to reference Gervais DA, McGovern FJ, Arellano RS, et al. Radiofrequency ablation of renal cell carcinoma: part 1, Indications, results, and role in patient management over a 6-year period and ablation of 100 tumors. AJR Am J Roentgenol. 2005;185(1):64–71. doi:10.2214/ajr.185.1.01850064.CrossRefPubMed Gervais DA, McGovern FJ, Arellano RS, et al. Radiofrequency ablation of renal cell carcinoma: part 1, Indications, results, and role in patient management over a 6-year period and ablation of 100 tumors. AJR Am J Roentgenol. 2005;185(1):64–71. doi:10.​2214/​ajr.​185.​1.​01850064.CrossRefPubMed
6.
go back to reference Matsuda Y, Kawata S, Nagase T, et al. Interleukin-6 in transcatheter arterial embolization for patients with hepatocellular carcinoma. Effects of serine protease inhibitor. Cancer. 1994;73(1):53–7.CrossRefPubMed Matsuda Y, Kawata S, Nagase T, et al. Interleukin-6 in transcatheter arterial embolization for patients with hepatocellular carcinoma. Effects of serine protease inhibitor. Cancer. 1994;73(1):53–7.CrossRefPubMed
8.
go back to reference Delworth MG, Pisters LL, Fornage BD, et al. Cryotherapy for renal cell carcinoma and angiomyolipoma. The Journal of urology. 1996;155(1):252–4 (discussion 54-5).CrossRefPubMed Delworth MG, Pisters LL, Fornage BD, et al. Cryotherapy for renal cell carcinoma and angiomyolipoma. The Journal of urology. 1996;155(1):252–4 (discussion 54-5).CrossRefPubMed
11.
go back to reference Dunne RM, Shyn PB, Sung JC, et al. Percutaneous treatment of hepatocellular carcinoma in patients with cirrhosis: a comparison of the safety of cryoablation and radiofrequency ablation. Eu J Radiol. 2014;83(4):632–8. doi:10.1016/j.ejrad.2014.01.007.CrossRef Dunne RM, Shyn PB, Sung JC, et al. Percutaneous treatment of hepatocellular carcinoma in patients with cirrhosis: a comparison of the safety of cryoablation and radiofrequency ablation. Eu J Radiol. 2014;83(4):632–8. doi:10.​1016/​j.​ejrad.​2014.​01.​007.CrossRef
13.
go back to reference Wang C, Wang H, Yang W, et al. Multicenter randomized controlled trial of percutaneous cryoablation versus radiofrequency ablation in hepatocellular carcinoma. Hepatology. 2015;61(5):1579–90. doi:10.1002/hep.27548.CrossRefPubMed Wang C, Wang H, Yang W, et al. Multicenter randomized controlled trial of percutaneous cryoablation versus radiofrequency ablation in hepatocellular carcinoma. Hepatology. 2015;61(5):1579–90. doi:10.​1002/​hep.​27548.CrossRefPubMed
16.
17.
18.
go back to reference Allison DJ, Jordan H, Hennessy O. Therapeutic embolisation of the hepatic artery: a review of 75 procedures. Lancet. 1985;1(8429):595–9.CrossRefPubMed Allison DJ, Jordan H, Hennessy O. Therapeutic embolisation of the hepatic artery: a review of 75 procedures. Lancet. 1985;1(8429):595–9.CrossRefPubMed
20.
go back to reference Klimberg I, Hunter P, Hawkins IF, et al. Preoperative angioinfarction of localized renal cell carcinoma using absolute ethanol. J Urol. 1985;133(1):21–4.CrossRefPubMed Klimberg I, Hunter P, Hawkins IF, et al. Preoperative angioinfarction of localized renal cell carcinoma using absolute ethanol. J Urol. 1985;133(1):21–4.CrossRefPubMed
22.
go back to reference Slomka M, Radwan P. The evaluation of clinical results of hepatic artery embolization. Materia medica Polona. Pol J Med Pharm. 1992;24(2):193–5. Slomka M, Radwan P. The evaluation of clinical results of hepatic artery embolization. Materia medica Polona. Pol J Med Pharm. 1992;24(2):193–5.
23.
go back to reference Ikei S, Ogawa M, Beppu T, et al. Changes in IL-6, IL-8, C-reactive protein and pancreatic secretory trypsin inhibitor after transcatheter arterial chemo-embolization therapy for hepato-cellular carcinoma. Cytokine. 1992;4(6):581–4.CrossRefPubMed Ikei S, Ogawa M, Beppu T, et al. Changes in IL-6, IL-8, C-reactive protein and pancreatic secretory trypsin inhibitor after transcatheter arterial chemo-embolization therapy for hepato-cellular carcinoma. Cytokine. 1992;4(6):581–4.CrossRefPubMed
24.
go back to reference Itoh Y, Okanoue T, Ohnishi N, et al. Hepatic damage induced by transcatheter arterial chemoembolization elevates serum concentrations of macrophage-colony stimulating factor. Liver. 1999;19(2):97–103.CrossRefPubMed Itoh Y, Okanoue T, Ohnishi N, et al. Hepatic damage induced by transcatheter arterial chemoembolization elevates serum concentrations of macrophage-colony stimulating factor. Liver. 1999;19(2):97–103.CrossRefPubMed
26.
go back to reference Sacks D, McClenny TE, Cardella JF, et al. society of interventional radiology clinical practice guidelines. J Vas Interv Radiol JVIR. 2003;14(9 Pt 2):S199–202.CrossRef Sacks D, McClenny TE, Cardella JF, et al. society of interventional radiology clinical practice guidelines. J Vas Interv Radiol JVIR. 2003;14(9 Pt 2):S199–202.CrossRef
Metadata
Title
Incidence of Post-ablation Syndrome Following Image-Guided Percutaneous Cryoablation of Renal Cell Carcinoma: A Prospective Study
Authors
Jim Zhong
Janette Bambrook
Balbir Bhambra
Jonathan Smith
Jon Cartledge
Christy Ralph
Naveen Vasudev
Simon Whiteley
Tze Wah
Publication date
01-02-2018
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 2/2018
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-017-1811-1

Other articles of this Issue 2/2018

CardioVascular and Interventional Radiology 2/2018 Go to the issue