Safety and efficacy of CT-guided percutaneous cryoablation for renal cell carcinoma

J Vasc Interv Radiol. 2008 Sep;19(9):1302-10. doi: 10.1016/j.jvir.2008.05.015. Epub 2008 Jul 11.

Abstract

Purpose: Image-guided percutaneous cryoablation is a treatment alternative for selected patients with renal cell carcinoma (RCC). The objective of the present study was to present the safety and efficacy of percutaneous cryoablation.

Materials and methods: The study included 51 lesions in 46 consecutive patients treated with computed tomography (CT)-guided percutaneous cryoablation. Results were based on 40 RCCs with follow-up. Patients had baseline history and physical and laboratory examinations and renal CT or magnetic resonance (MR) imaging and were followed every 3 months. Biopsy of all lesions was performed before or at the time of the procedure. Efficacy was defined as a complete lack of enhancement on follow-up contrast agent-enhanced CT or MR imaging. Lesion size was also followed and correlated with lack of enhancement. Short- and long-term complications were tabulated.

Results: The technical success rate was 100%, with 20% of cases requiring some form of thermal protection of an adjacent organ. During follow-up (median, 28 weeks; range, 4-81 weeks), the efficacy rate was 100% for lesions smaller than 7 cm. The incidence of significant complications was 18% (8% CTAE), mostly (10%) intercostal or genitofemoral nerve injury. All patients with complications recovered fully, and there were no mortalities. There was no change in creatinine levels, and no patient developed renal failure as a result of cryoablation.

Conclusions: CT-guided percutaneous cryoablation resulted in complete response for lesions as large as 4 cm. It may also be a viable alternative for nonsurgical candidates with lesions as large as 7 cm. It has a high efficacy rate, and its modest complications are not only comparable to those of other treatment modalities, but also appear to be reversible.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Renal Cell / surgery*
  • Cryosurgery / adverse effects*
  • Cryosurgery / methods*
  • Female
  • Humans
  • Kidney Neoplasms / surgery*
  • Male
  • Middle Aged
  • Radiography, Interventional / methods*
  • Surgery, Computer-Assisted / methods*
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome