Percutaneous CT-Guided Renal Cryoablation: Technical Aspects, Safety, and Long-Term Oncological Outcomes in a Single Center

Abstract

Background and objectives: Cryoablation is emerging as a safe and effective therapeutic option for treating renal cell carcinoma. This study analyzed the safety and long-term oncological outcomes of cryoablation in our center. Materials and methods: Patients who underwent computed tomography (CT)-guided percutaneous cryoablation between February 2011 and June 2020 for one or more clinically localized renal tumors were identified. Technical success and treatment efficacy were assessed. Post-procedural complications were classified according to the Clavien-Dindo system. Recurrence–free survival was determined for biopsy-proven malignant renal tumors. Results: A total of 174 renal tumors, 78 of which were biopsy-proven malignant carcinomas, were treated in 138 patients (97 males and 41 females, mean age: 73 years, range: 43–89 years). Mean tumor size was 2.25 cm and 54.6% of the lesions required a complex approach. Technical success was achieved in 171 out of 174 tumors (98.3%). Primary treatment efficacy was 95.3% and increased to 98.2% when retreats were taken into account. The overall complication rate was 29.8%. No complications of Clavien-Dindo grade III or more were encountered. Median follow-up was 21.92 months (range: 0.02–99.87). Recurrence-free survival was 100% at 1 year, 95.3% (95% CI: 82.1%–98.8%) at 3 years, and 88.6% (95% CI: 71.8%–95.7%) at 5 years. Conclusions: Cryoablation is a safe and effective technique for the treatment of small renal lesions, with no major complications when performed by expert interventional radiologists. The multidisciplinary discussion is essential, especially considering the high number of histologically undetermined lesions. Our long-term oncological outcomes are encouraging and in line with the literature.

Early postoperative complications after liquid nitrogen – based cryoablation therapy for localized kidney cancer

“…Она является наиболее оправданной при лечении локализованного рака почки. В зарубежных источниках приводится только сравнение доступа при криоаблации [5] или описание всех аблативных методик [6], или преимущества той или иной навигационной техники [7,8]. В качестве объективного инструмента для описания анатомической сложности локализации опухоли, предсказывающего потенциальный риск развития осложнений после минимально инвазивных вмешательств, в настоящее время рассматриваются различные системы нефрометрии.…”

Imaging of the Kidney and Urinary Tract: Current and Future Trends

“…Cryoablation is emerging as a safe and effective therapeutic option for treating renal cell carcinoma. Technical success, primary treatment efficacy and recurrence-free survival of the procedure have proven to be very close to surgical results in properly selected patients with very few major complications [ 5 ]. The multidisciplinary discussion plays fundamental role in choosing the best therapeutic approach for each patient with solid renal masses, patients with small renal tumors (pT1a) and patients at risk for surgery being the best candidates for the procedure.…”