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Percutaneous Cryoablation of Large Tumors: Safety, Feasibility, and Technical Considerations

  • Clinical Investigation
  • Non-Vascular Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Introduction

Large tumors may prove unsuitable for surgical cure or other local therapies due to their size, involvement of critical structures, prior non-ablative treatment failure, or coexisting disease burden. This study was performed to assess the safety and feasibility of percutaneous cryoablation for treatment of large tumors exceeding 6 cm in size, and to highlight the key technical considerations inherent to such cases.

Materials and Methods

This single-institution retrospective study identified 77 patients (42 male, 35 female; median age 55 years) who underwent 96 cryoablation procedures for treatment of 78 tumors (mean diameter 9.8 ± 3.6 cm) from 2008 through 2020. Technical success, procedure-related complications, mortality, oncologic outcomes, and procedural logistics were evaluated. Technical success was defined as ice ball extension at least 5 mm beyond the tumor margins.

Results

Intentional subtotal ablations were performed in 32% of cases due to tumor encroachment on vulnerable structures or as part of staged/combined therapies. Of the 68% of cases that were planned for complete ablation, the technical success rate was 100%. Major complications occurred after 19/96 (20%) procedures, with hemorrhage and acute kidney injury each occurring in 6/96 (6%). Post-procedural myositis occurred in 24/96 (25%) cases and was not considered a major complication in the absence of acute kidney injury. Local recurrence occurred in 2/23 (8.7%) of patients undergoing ablation for cure or local control at a median follow-up duration of 13 months.

Conclusion

Percutaneous cryoablation may be used to treat large (> 6 cm) tumors with a high degree of technical success and an acceptable safety profile.

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA

    Ahmad Parvinian, A. Nicholas Kurup, Tom D. Atwell, Grant D. Schmit, John J. Schmitz & Jonathan M. Morris

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  1. Ahmad Parvinian
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  2. A. Nicholas Kurup
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  3. Tom D. Atwell
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  4. Grant D. Schmit
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  5. John J. Schmitz
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  6. Jonathan M. Morris
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Correspondence to Ahmad Parvinian.

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Conflict of interest

Dr. Kurup reports personal fees from Wolters Kluwer (UpToDate), grants from Philips, grants from EDDA Technology, and grants from Galil Medical/BTG. Dr. Morris reports personal fees from Merit and Medtronic. The remaining authors declare that they have no conflict of interest.

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This study has obtained IRB approval from the Mayo Clinic Institutional Review Board, and the need for informed consent was waived.

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Parvinian, A., Kurup, A.N., Atwell, T.D. et al. Percutaneous Cryoablation of Large Tumors: Safety, Feasibility, and Technical Considerations. Cardiovasc Intervent Radiol 45, 69–79 (2022). https://doi.org/10.1007/s00270-021-03025-7

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  • DOI: https://doi.org/10.1007/s00270-021-03025-7

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