TY - JOUR
T1 - Percutaneous Cryoablation of Renal Cell Carcinoma with Sinus Vein Involvement Based on Preprocedural Imaging
AU - Atwell, Thomas D.
AU - Kurup, A. Nicholas
AU - Boorjian, Stephen A.
AU - Schmitz, John J.
AU - Thompson, R. Houston
AU - Leibovich, Bradley C.
AU - Schmit, Grant D.
PY - 2017
Y1 - 2017
N2 - Purpose: To assess feasibility, safety, and oncologic outcomes of cryoablation in treatment of renal cell carcinoma (RCC) with extension into adjacent renal sinus vein. Materials and Methods: Review of an internally maintained renal ablation registry identified 7 patients (4 men and 3 women; median age 62 y; age range, 45-91 y) who underwent percutaneous cryoablation of RCC with imaging consistent with extension of tumor into an immediately adjacent renal sinus vein. Four of 7 (57%) patients had recurrent tumors following prior partial nephrectomy. Three of 7 patients (43%) had solitary kidneys. Results: Median tumor size was 4.3 cm (range, 1.9-5.0 cm). Biopsy showed RCC in 6 of 7 patients. Technical success was achieved in 6 of 7 tumors (86%) There was a single Clavien grade 3 major complication. Median hospital stay was 1 night (range, 1-3 nights). Follow-up imaging performed in the 6 successfully treated patients at median 11 months (range, 2-101 months) showed no local tumor progression. In 2 patients with solitary kidneys, estimated glomerular filtration rate declined from 63 mL/min/1.73 m2 to 45 mL/min/1.73 m2 and 67 mL/min/1.73 m2 to 40 mL/min/1.73 m2 at 101 months and 12 months following treatment, respectively. Estimated glomerular filtration rate remained > 60 mL/min/1.73 m2 in the remaining patients. Conclusions: In this small select group of patients, percutaneous cryoablation afforded a safe and, based on early outcomes, effective means of providing local control of locally invasive RCC. Percutaneous cryoablation may obviate the need for nephrectomy in similar patients.
AB - Purpose: To assess feasibility, safety, and oncologic outcomes of cryoablation in treatment of renal cell carcinoma (RCC) with extension into adjacent renal sinus vein. Materials and Methods: Review of an internally maintained renal ablation registry identified 7 patients (4 men and 3 women; median age 62 y; age range, 45-91 y) who underwent percutaneous cryoablation of RCC with imaging consistent with extension of tumor into an immediately adjacent renal sinus vein. Four of 7 (57%) patients had recurrent tumors following prior partial nephrectomy. Three of 7 patients (43%) had solitary kidneys. Results: Median tumor size was 4.3 cm (range, 1.9-5.0 cm). Biopsy showed RCC in 6 of 7 patients. Technical success was achieved in 6 of 7 tumors (86%) There was a single Clavien grade 3 major complication. Median hospital stay was 1 night (range, 1-3 nights). Follow-up imaging performed in the 6 successfully treated patients at median 11 months (range, 2-101 months) showed no local tumor progression. In 2 patients with solitary kidneys, estimated glomerular filtration rate declined from 63 mL/min/1.73 m2 to 45 mL/min/1.73 m2 and 67 mL/min/1.73 m2 to 40 mL/min/1.73 m2 at 101 months and 12 months following treatment, respectively. Estimated glomerular filtration rate remained > 60 mL/min/1.73 m2 in the remaining patients. Conclusions: In this small select group of patients, percutaneous cryoablation afforded a safe and, based on early outcomes, effective means of providing local control of locally invasive RCC. Percutaneous cryoablation may obviate the need for nephrectomy in similar patients.
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U2 - 10.1016/j.jvir.2017.08.008
DO - 10.1016/j.jvir.2017.08.008
M3 - Article
C2 - 29042169
AN - SCOPUS:85031399819
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
SN - 1051-0443
ER -