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.
N1 - Funding Information:
A.N.K. received a research grant from Galil Medical (Arden Hills, Minnesota) and receives royalties from UpToDate (Waltham, Massachusetts). None of the other authors have identified a conflict of interest.
Publisher Copyright:
© 2017 SIR
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2017/12
Y1 - 2017/12
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
SN - 1051-0443
VL - 28
SP - 1651
EP - 1657
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 12
ER -