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Efficacy and Safety of Percutaneous Cryoablation for Stage 1A/B Renal Cell Carcinoma: Results of a Prospective, Single-Arm, 5-Year Study

CardioVascular and Interventional Radiology volume 37, pages 1494–1499 (2014)Cite this article

Abstract

Purpose

Percutaneous cryoablation is gaining in popularity as a viable treatment option for renal cell carcinoma (RCC). We present the 5-year oncologic outcomes of a prospective trial.

Methods

Over a 5-year period, we treated 134 consecutive patients with biopsy-proven RCC with CT-guided percutaneous cryoablation. All were treated while under conscious sedation. Technical objective was for the ice ball to cover the lesion plus a 5-mm margin. Hydro- or air dissection was utilized to aid in technical success as needed. Efficacy was defined as the lack of enhancement and/or enlargement of a previously enhancing lesion on follow-up imaging. Safety was assessed by the common terminology criteria for adverse events (CTCAE), version 4.0.

Results

The 1-, 2-, 3-, 4-, and 5-year efficacy of percutaneous cryoablation for RCC was 99.2, 99.2, 98.9, 98.5, and 97.0 %, respectively. Median tumor size was 2.8 ± 1.4 cm. All-cause mortality during the study period was 3 (none from RCC), yielding an overall 5-year survival of 97.8 %. The cancer-specific 5-year survival was 100 %. No patient developed metastatic disease during the follow-up period. The overall significant CTCAE version 4.0 complication rate was 6 %, with the most frequent being transfusion-requiring hemorrhage, at 1.6 %. There was one 30-day mortality unrelated to the procedure.

Conclusion

CT-guided percutaneous cryoablation for renal cancer offers very high efficacy, approaching that of the gold standard, with a more favorable safety profile.

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Conflict of interest

Christos S. Georgiades is a consultant for Galil and Endocare. Ron Rodriguez declares that he has no conflict of interest.

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Authors and Affiliations

  1. Vascular and Interventional Radiology, American Medical Center, 215 Spyrou Kyprianou Avenue, 2047, Nicosia, Cyprus

    Christos S. Georgiades

  2. Urologic Surgery, University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA

    Ron Rodriguez

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  1. Christos S. Georgiades
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  2. Ron Rodriguez
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Correspondence to Christos S. Georgiades.

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Georgiades, C.S., Rodriguez, R. Efficacy and Safety of Percutaneous Cryoablation for Stage 1A/B Renal Cell Carcinoma: Results of a Prospective, Single-Arm, 5-Year Study. Cardiovasc Intervent Radiol 37, 1494–1499 (2014). https://doi.org/10.1007/s00270-013-0831-8

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  • DOI: https://doi.org/10.1007/s00270-013-0831-8

Keywords

  • Cryoablation
  • Renal cancer
  • RCC
  • Ablation
  • Percutaneous