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Cryoablation of renal cell carcinoma for patients with stage 4 or 5 non-dialysis chronic kidney disease

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Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the safety and efficacy of cryoablation for renal cell carcinoma (RCC) in patients with stage 4 or 5 non-dialysis chronic kidney disease (CKD).

Materials and methods

This retrospective multicenter study included patients with maximum tumor diameter ≤ 4 cm, estimated glomerular filtration rate (eGFR) < 30 ml/min/1.73 m2, in whom cryoablation was performed percutaneously with curative intent between July 2011 and May 2016.

Results

Of 541 patients who underwent renal tumor cryoablation, 17 (3.1%; 4 women, 13 men; mean age 70.1 ± 10.6 years) with stage 4 or 5 non-dialysis CKD were included in this study. The pre-cryoablation eGFR was 22.5 ± 6.3 ml/min/1.73 m2. The mean tumor diameter was 2.8 ± 0.7 cm. No Grade 3 or higher adverse events occurred post-cryoablation. The eGFR at each time point was significantly lower than that before treatment. One patient required hemodialysis initiation at 21 months post-procedure. None of the patients showed residual RCC at their last follow-up.

Conclusion

Cryoablation of RCC is safe in patients with stage 4 or 5 non-dialysis CKD and yields treatment results comparable to those in patients without CKD. This treatment could be completed without the early initiation of hemodialysis after the procedure.

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Authors and Affiliations

  1. Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Hideo Gobara, Yusuke Matsui, Toshihiro Iguchi & Takao Hiraki

  2. Department of Interventional Radiology, Mie University Hospital, Tsu, Japan

    Atsuhiro Nakatsuka

  3. Department of Radiology, The Jikei University School of Medicine, Kashiwa Hospital, Kashiwa, Japan

    Kanichiro Shimizu & Takashi Yamanaka

  4. Department of Radiology, The Hospital of Hyogo College of Medicine, Nishinomiya, Japan

    Koichiro Yamakado

Authors
  1. Hideo Gobara
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  2. Atsuhiro Nakatsuka
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  3. Kanichiro Shimizu
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  4. Takashi Yamanaka
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  5. Yusuke Matsui
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  6. Toshihiro Iguchi
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  7. Takao Hiraki
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  8. Koichiro Yamakado
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Corresponding author

Correspondence to Hideo Gobara.

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Conflict of interest

Hideo Gobara and Takao Hiraki received funding from Okayama Prefecture, JPSS and AMED. Other authors have no conflict of interest to declare.

Ethical statement

Each institutional review board approved this retrospective multicenter study and waived the requirement for obtaining informed consent to use the patients’ medical data. All procedures performed were in accordance with the ethical standards of the institutional research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Gobara, H., Nakatsuka, A., Shimizu, K. et al. Cryoablation of renal cell carcinoma for patients with stage 4 or 5 non-dialysis chronic kidney disease. Jpn J Radiol 37, 481–486 (2019). https://doi.org/10.1007/s11604-019-00821-7

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  • DOI: https://doi.org/10.1007/s11604-019-00821-7

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