CT-Guided Percutaneous Cryoablation in Renal Cell Carcinoma: Factors Affecting Local Tumor Control

Yamanaka, Takashi; Yamakado, Koichiro; Yamada, Tomomi; Fujimori, Masashi; Takaki, Haruyuki; Nakatsuka, Atsuhiro; Sakuma, Hajime; Sugimura, Yoshiki

doi:10.1016/j.jvir.2015.04.031

Cited by 32 publications

(21 citation statements)

References 24 publications

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“…Second local progression after repeat cryoablation for RCC is rare [3,4]. A large tumor size (> 3 cm) and insufficient ice-ball margin (< 6 mm) are risk factors for local progression after percutaneous cryoablation [4,6]. Yamanaka et al reported a case of RCC located between the renal artery and vein, showing a second local progression after repeat cryoablation [4].…”

Section: Discussionmentioning

confidence: 99%

“…Recurring local progression, i.e., local failure following repeat cryoablation for a locally progressed tumor, is rare, as long as the repeat ablation is performed with an adequate ice-ball margin. Nevertheless, we recently experienced three cases of RCC with recurring local progression after repeat cryoablation despite a sufficiently large ice-ball margin (≥ 6 mm) [4,5]. Here, we describe the details of those cases.…”

Section: Introductionmentioning

confidence: 95%

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Recurring Local Tumor Progression After Cryoablation of Renal Cell Carcinoma

Okamoto

Matsui

Hiraki

et al. 2020

Interventional Radiology

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We describe three cases of renal cell carcinoma (RCC) with recurring local tumor progression, i.e., local failure following repeat cryoablation for a locally progressed tumor. A second local progression developed in all cases after cryoablation for the first local progression, despite there being a sufficiently large ice-ball margin. In two cases, the second local progression was treated with microwave ablation and controlled in the follow-up. In one case, a third cryoablation was performed, but a third local progression developed after 12 months. These cases suggest that some RCCs may be refractory to cryoablation. In cases of recurring local progression, switching from cryoablation to another ablation modality may be an alternative.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

Recurring Local Tumor Progression After Cryoablation of Renal Cell Carcinoma

Okamoto

Matsui

Hiraki

et al. 2020

Interventional Radiology

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“…Thus, RFA of a 2-cm mass ablates approximately 10 cm 3 of normal tissue, whereas cryoablation treatment ablates 30 cm 3 of normal tissue ( 68 ). The location of the tumor within the kidney plays a critical role in treatment success, as centrally located tumors more frequently fail effective tumor cell destruction ( 69 – 71 ). Treatment failure is also significantly associated with tumor size >4 cm ( 72 ).…”

Section: Current Treatment Strategiesmentioning

confidence: 99%

Renal Cell Carcinoma in von Hippel–Lindau Disease—From Tumor Genetics to Novel Therapeutic Strategies

Kim

Zschiedrich

2018

Front. Pediatr.

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von Hippel–Lindau (VHL) disease is an autosomal dominant syndrome caused by mutations in the VHL tumor-suppressor gene, leading to the dysregulation of many hypoxia-induced genes. Affected individuals are at increased risk of developing recurrent and bilateral kidney cysts and dysplastic lesions which may progress to clear cell renal cell carcinoma (ccRCC). Following the eponymous VHL gene inactivation, ccRCCs evolve through additional genetic alterations, resulting in both intratumor and intertumor heterogeneity. Genomic studies have identified frequent mutations in genes involved in epigenetic regulation and phosphoinositide 3-kinase–AKT–mechanistic target of rapamycin (mTOR) pathway activation. Currently, local therapeutic options include nephron-sparing surgery and alternative ablative procedures. For advanced metastatic disease, systemic treatment, including inhibition of vascular endothelial growth factor pathways and mTOR pathways, as well as immunotherapy are available. Multimodal therapy, targeting multiple signaling pathways and/or enhancing the immune response, is currently being investigated. A deeper understanding of the fundamental biology of ccRCC development and progression, as well as the development of novel and targeted therapies will be accelerated by new preclinical models, which will greatly inform the search for clinical biomarkers for diagnosis, prognosis, and response to treatment.

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“…Thermal ablation techniques, which are nephron‐sparing non‐surgical approaches, could be an alternative treatment option mainly recommended for frail patients . The well‐known thermal ablation techniques include radiofrequency ablation, cryoablation and microwave ablation . Previous research comparing radiofrequency ablation with cryoablation for renal tumors showed no significant differences in treatment effects and side‐effects .…”

Section: Introductionmentioning

confidence: 99%

“…As its efficacy is comparable to nephrectomy, renal cryoablation has become an accepted treatment for small renal tumors as an alternative to surgery, especially in patients who are poor candidates for surgery and patients with multiple renal tumors or a single kidney . In Japan the number of patients undergoing percutaneous cryoablation has been increasing, particularly since its appearance on the list of approved procedures by the Japanese national health insurance program in 2011 …”

Section: Introductionmentioning

confidence: 99%

Protection from injury of organs adjacent to a renal tumor during percutaneous cryoablation

et al. 2019

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Renal cryoablation has become accepted as treatment for small renal tumors as an alternative to surgery. However, parallel with the increase in the use of this therapy, there also has been increases in the number of reports of complications related to renal cryoablation. One potential complication is injury to important non-renal structures adjacent to the ablated renal tumor, such as the colon, duodenum, ureter, psoas muscle and so on. To prevent injury of adjacent organs, separating organs from the tumor is desirable. Over the past 15 years, several techniques have been developed to protect against injury of organs adjacent to renal tumors that are targets of cryoablation. The most commonly used technique for this purpose has been hydrodissection. Others include dissection with gas, balloon dissection and probe traction. To avoid injury of a ureter running near the renal tumor, pyeloperfusion is known to be useful. The rate of cases necessitating avoidance of organ injury by using these techniques is relatively high. In some cases, more than two techniques are combined. In the present review, we provided an overview of techniques currently available to protect against organ injuries, and discussed the advantages and disadvantages of each technique.

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CT-Guided Percutaneous Cryoablation in Renal Cell Carcinoma: Factors Affecting Local Tumor Control

Cited by 32 publications

References 24 publications

Recurring Local Tumor Progression After Cryoablation of Renal Cell Carcinoma

Recurring Local Tumor Progression After Cryoablation of Renal Cell Carcinoma

Renal Cell Carcinoma in von Hippel–Lindau Disease—From Tumor Genetics to Novel Therapeutic Strategies

Protection from injury of organs adjacent to a renal tumor during percutaneous cryoablation

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