Percutaneous cryoablation of stage T1b renal cell carcinoma: technique considerations, safety, and local tumor control.
J Vasc Interv Radiol
; 26(6): 792-9, 2015 Jun.
Article
in En
| MEDLINE
| ID: mdl-25824313
PURPOSE: To describe the technical methods, safety, and local tumor control rate associated with percutaneous cryoablation of stage T1b renal cell carcinoma (RCC). MATERIALS AND METHODS: A retrospective review of a percutaneous renal ablation registry was used to identify 46 patients with a total of 46 biopsy-proven RCC lesions measuring 4.1-7.0 cm treated with cryoablation between 2003 and 2011. The main outcome parameters investigated were adjunctive maneuvers, complications, and local tumor progression, and cancer-specific survival rates. Complication rates were categorized and recorded using the Clavien-Dindo classification system. Progression-free and cancer-specific survival rates were estimated using the Kaplan-Meier method. RESULTS: The mean treated RCC size was 4.8 cm (range, 4.1-6.4 cm). Prophylactic tumor embolization was performed in 7 patients (15%), ipsilateral ureteral stents were placed in 7 patients (15%), and hydrodisplacement of bowel was performed in the treatment of 16 tumors (35%). A single technical failure (2.2%) was observed at the time of ablation. Thirty-six tumors (78%) had follow-up imaging at 3 months or later following ablation, including a single recurrence at 9 months after ablation. The mean duration of follow-up for the 35 RCC tumors that did not recur was 2.0 years (range, 0.3-6.1 y). Estimated local progression-free survival rate at 3 years was 96.4%. Of the 46 cryoablation procedures, there were 7 complications (15.2%) of grade II or worse. CONCLUSIONS: The results suggest that cryoablation represents a valid treatment alternative for select patients with clinical stage T1b RCC. Complications are frequent enough that multidisciplinary patient management should be considered.
Full text:
1
Collection:
01-internacional
Health context:
1_ASSA2030
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2_ODS3
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6_ODS3_enfermedades_notrasmisibles
Database:
MEDLINE
Main subject:
Carcinoma, Renal Cell
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Cryosurgery
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Kidney Neoplasms
Type of study:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limits:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Language:
En
Journal:
J Vasc Interv Radiol
Year:
2015
Document type:
Article