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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 3/2011

01-06-2011 | Clinical Investigation

Prospective Analysis of the Safety and Efficacy of Percutaneous Cryoablation for pT1NxMx Biopsy-Proven Renal Cell Carcinoma

Authors: Ronald Rodriguez, Ziga Cizman, Kelvin Hong, Alexandra Koliatsos, Christos Georgiades

Published in: CardioVascular and Interventional Radiology | Issue 3/2011

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Abstract

Purpose

Our objective was to determine the efficacy and safety of image-guided, percutaneous cryoablation for American Joint Committee on Cancer pT1ANxMx and pT1BNxMx biopsy-proven renal cell carcinoma (RCC).

Materials and Methods

Computed tomography (CT)-guided, percutaneous cryoablation was used to treat 117 renal lesions in 113 consecutive patients with pT1NxMx RCC. All 117 ablations were included in the safety analysis, and complications were categorized according to Common Terminology Criteria for Adverse Events version 3.0 (CTCAE v3.0). Eighty-one lesions were biopsy-proven RCC and were included in the efficacy analysis. Technical success was defined as the “ice-ball” covering the entire lesion plus a minimum 5-mm margin. Efficacy was defined as complete lack of enhancement and continuous decrease in size on subsequent follow-up imaging studies.

Results

Technical success was 100%, with 15% of ablations requiring air or saline injection to prevent nontarget ablation. We recorded a 7% rate of clinically significant complications (CTCAE category ≥2) and 0% mortality. Renal function was not adversely affected. Seventy percent of patients were discharged to home on the same day. Efficacy was 98.7% for a median follow-up of 67 weeks (range 7–172). For the subgroup of patients that reached a median follow-up of 2 (n = 59) and 3 years (n = 13), efficacy was 98.3 and 92.3%, respectively. Cancer specific survival was 100%.

Conclusions

CT-guided, percutaneous cryoablation has an excellent safety and efficacy profile for stage T1A and T1B RCC; however, longer follow-up is needed to compare it with other nephron-sparing surgical treatments. It is a great option for nonsurgical patients, those in whom renal function cannot be further sacrificed, and those at risk for metachronous lesions.
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Metadata
Title
Prospective Analysis of the Safety and Efficacy of Percutaneous Cryoablation for pT1NxMx Biopsy-Proven Renal Cell Carcinoma
Authors
Ronald Rodriguez
Ziga Cizman
Kelvin Hong
Alexandra Koliatsos
Christos Georgiades
Publication date
01-06-2011
Publisher
Springer-Verlag
Published in
CardioVascular and Interventional Radiology / Issue 3/2011
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-010-9934-7

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