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Japanese Journal of Radiology
Published in: Japanese Journal of Radiology 9/2023

Open Access 01-04-2023 | Kidney Cancer | Original Article

Renal cryoablation combined with prior transcatheter arterial embolization in non-dialysis patients with stage 4 or 5 chronic kidney disease: a retrospective study

Authors: Noriyuki Umakoshi, Toshihiro Iguchi, Yusuke Matsui, Koji Tomita, Mayu Uka, Takahiro Kawabata, Kazuaki Munetomo, Shoma Nagata, Hideo Gobara, Motoo Araki, Takao Hiraki

Published in: Japanese Journal of Radiology | Issue 9/2023

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Abstract

Purpose

To retrospectively evaluate cryoablation combined with prior transcatheter arterial embolization (TAE) for renal cell carcinoma (RCC) in non-dialysis patients with stage 4 or 5 chronic kidney disease (CKD).

Materials and methods

Patients with stage 4 or 5 CKD undergoing TAE and cryoablation for RCC between May 2012 and October 2021 were included. TAE was selectively performed using iodized oil with absolute ethanol or gelatin sponge 1–14 days before cryoablation. Local efficacy, safety, and changes in renal function were evaluated.

Results

Nine patients (seven men and two women; median age, 64 years; range 52–88 years) with nine RCCs (mean diameter, 3.0 ± 1.0 cm; range 1.7–4.7 cm) were included. The mean pre-treatment estimated glomerular filtration rate (eGFR) was 24.2 ± 5.6 ml/min/1.73 m2 (range 10.4–29.2 ml/min/1.73 m2). The mean amount of contrast medium used in TAE was 58 ± 29 ml (range 40–128 ml). Except in one patient (grade 3 pyelonephritis), no grade ≥ 3 complications occurred. During the follow-up period (median, 18 months; range 7–54 months), no local tumor progression occurred. In two patients with pre-treatment eGFR of < 20 ml/min/1.73 m2, hemodialysis was initiated at 3 and 19 months after cryoablation. At their last follow-up, the remaining seven patients showed a decrease of 6.2 ± 5.3 ml/min/1.73 m2 (range 0.7–17.2 ml/min/1.73 m2) in their eGFR.

Conclusion

Cryoablation combined with TAE for RCC in non-dialysis patients with stage 4 or 5 CKD was effective and safe, with an acceptable impact on renal function.
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Metadata
Title
Renal cryoablation combined with prior transcatheter arterial embolization in non-dialysis patients with stage 4 or 5 chronic kidney disease: a retrospective study
Authors
Noriyuki Umakoshi
Toshihiro Iguchi
Yusuke Matsui
Koji Tomita
Mayu Uka
Takahiro Kawabata
Kazuaki Munetomo
Shoma Nagata
Hideo Gobara
Motoo Araki
Takao Hiraki
Publication date
01-04-2023
Publisher
Springer Nature Singapore
Published in
Japanese Journal of Radiology / Issue 9/2023
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-023-01416-z

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