Outcomes of cryoablation for small renal masses: a single-institution study
Keywords:Cryoablation, Small renal masses, Renal tumours, Cryosurgery
Background: The current study reports the clinical outcomes of the efficacy of computerized tomography (CT) guided cryoablation (CA) in the treatment of patients with small renal masses.
Methods: This retrospective single institution study analyses the clinical outcomes of 36 renal tumours that were managed with cryoablation. Patient age, sex, tumour size, complications and recurrences were recorded. These patients were followed up at 3,6- and 12-months interval, they underwent biopsy and abdominal contrast enhanced ultrasound (CEUS) depending upon indications.
Results: 36 patients (63.9% male, 19.4% female) each with a single small renal mass had CA with a follow-up at 3, 6 and 12 months. The mean tumour size was 606.9±31.8 mm2. Eleven complications occurred in 36 patients, for an overall complication rate of 30.6%. One (2.7%) patient had enhancement at the surgical bed on initial imaging and were considered incomplete ablations. None of the patients showed signs of distant metastases at the 3, 6 and 12-month follow-ups.
Conclusions: Cryoablation of renal masses results in acceptable oncologic efficacy with an acceptable number of complications. Therefore, it remains a viable treatment for renal masses.
Ljungberg B, Albiges L, Abu-Ghanem Y, Bensalah K, Dabestani S, Fernández-Pello S, et al. European Association of Urology Guidelines on Renal Cell Carcinoma: The 2019 Update. Eur Urol. 2019;75(5):799-810.
Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zinke H. Solid renal tumors: an analysis of pathologic features related to tumor size. J Urol. 2003;170:2217-20.
Mouraviev V, Joniau S, Van Poppel H, Polascik TJ. Current status of minimally invasive ablative techniques in the treatment of small renal tumours. Eur Urol. 2007;51:328-36.
Fergany AF, Hafez KS, Novick AC. Long- term results of nephron-sparing surgery for localized renal cell carcinoma: 10-year follow-up. J Urol. 2000;163:442-5.
Gill IS, Matin SF, Desai MM. Comparative analysis of laparoscopic versus open par- tial nephrectomy for renal tumors in 200 patients. J Urol. 2003;170:64-8.
Olweny EO, Park SK, Tan YK, Best SL, Trimmer C, Cadeddu JA. Radiofrequency ablation versus partial nephrectomy in patients with solitary clinical T1a renal cell carcinoma: comparable oncologic outcomes at a minimum of 5 years of fol- low-up. Eur Urol. 2012;61:1156-61.
Zondervan PJ, Buijs M, de la Rosette JJ, van Delden O, van Lienden K, Laguna MP. Cryoablation of small kidney tumors. Int J Surgery. 2016;36:533-40.
Atwell TD, Vlaminck JJ, Boorjian SA, Kurup AN, Callstrom MR. Percutaneous cryoablation of stage T1b renal cell carcinoma: technique considerations, safety, and local tumor control. J Vasc Interv Radiol. 2015;26:792-9.
Weld KJ, Figenshau RS, Venkatesh R, Bhayani SB, Ames CD, Clayman RV, Landman J. Laparoscopic cryoablation for small renal masses: three-year follow- up. Urology. 2007;69:448-51.
Aron M, Gill IS. Minimally invasive nephron-sparing surgery (MINSS) for renal tumors. Eur Urol. 2007;51:348-57.
Aron M, Kamoi K, Remer E, Berger A, Desai M, Gill I. Laparoscopic renal cryoablation: 8-year, single surgeon outcomes. J Urol. 2010;183:889-95.
Gorski MJ, Deziel DJ, Staren ED. Cryosurgical ablation of hepatic neoplasm. Surg Technol Int. 1994;4:85.
Atwell TD, Farrell MA, Leibovich BC, Callstrom MR, Chow GK, Blute ML, Charboneau JW. Percutaneous renal cryoablation: experience treating 115 tumors. J Urol. 2008;179:2136-41.
Gill IS, Kavoussi LR, Lane BR, Blute ML, Babineau D, Colombo JR. Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol. 2007;178:41-6.
Weld KJ, Figenshau RS, Venkatesh R, Bhayani SB, Ames CD, Clayman RV, Landman J. Laparoscopic cryoablation for small renal masses: three-year follow-up. Urology. 2007;69:448-51.
Tsivian M, Caso J, Kimura M, Polascik TJ. Renal function outcomes after laparoscopic renal cryoablation. J Endourol. 2011;25(8):1287-91.
Kunkle DA, Uzzo RG. Cryoablation or radiofrequency ablation of the small renal mass: A meta-analysis. Cancer. 2008;113:2671-80.
Kunkle DA, Egleston BL, Uzzo RG. Excise, ablate or observe: The small renal mass dilemma meta-analysis and review. J Urol. 2008;179:1227-34.
Lehman DS, Hruby GW, Phillips CK, McKiernan JM, Benson MC, Landman J. First prize (tie): laparoscopic renal cryoablation: efficacy and complica- tions for larger renal masses. J Endourol. 2008;22:1123-7.
Laguna MP, Beemster P, Kumar V, Klingler HC, Wyler S, Anderson C, et al. Perioperative morbidity of laparoscopic cryoablation of small renal masses with ultrathin probes: a European multicentre experience. Eur Urol. 2009;56:355-61.