Percutaneous Cryoablation of Solitary, Sporadic Renal Cell Carcinoma: Outcome Analysis Based on Clear-Cell versus Papillary Subtypes

Mustafa M. Haddad, Grant D. Schmit, A. Nicholas Kurup, John J. Schmitz, Stephen A. Boorjian, Jennifer Geske, R. Houston Thompson, Matthew R Callstrom, Thomas D. Atwell

Research output: Contribution to journalArticle

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Abstract

Purpose: To evaluate treatment outcomes with percutaneous cryoablation (PCA) based on renal cell carcinoma (RCC) histology. Methods and Materials: Patients treated with PCA for a solitary, sporadic stage T1a RCC from 2003 to 2016 were identified from a single institution's renal ablation registry. Patients with multiple tumors, history of RCC, or genetic syndromes associated with RCC (n = 60); no specific RCC subtype determined from core biopsy (n = 66); RCC subtype other than clear-cell or papillary (n = 7); or less than 3 mo of follow-up imaging (n = 5) were excluded. In total, 173 patients met study inclusion criteria. Oncologic outcomes, clinical outcomes, and complications were evaluated based on tumor subtype. Results: Of the 173 patients who underwent PCA for a stage T1a RCC, 130 (75%) had clear-cell RCC (ccRCC) and 43 (25%) had papillary RCC (pRCC). Median tumor size was 2.9 cm (range, 1.3–4.0 cm). Technically successful cryoablation was achieved in all 173 patients. Local tumor recurrence developed in 6 patients with ccRCC (4.6%), new renal tumors developed in 1 patient (0.8%), and metastatic RCC developed in 1 patient (0.8%) who also had local tumor recurrence. No patients with pRCC showed local tumor recurrence, new renal tumors, or metastatic disease. The 5-year disease-free survival rate in patients with ccRCC was 88%, compared with 100% in patients with pRCC (P =.48). Nine patients (5.2%), all with ccRCC, experienced major complications (P =.11). Conclusions: Percutaneous ablation is a viable treatment option for patients with clinical stage T1a pRCC and ccRCC. Percutaneous ablation may be a very favorable treatment strategy particularly for pRCC.

Original languageEnglish (US)
JournalJournal of Vascular and Interventional Radiology
DOIs
StateAccepted/In press - Jan 1 2018

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Cryosurgery
Renal Cell Carcinoma
Neoplasms
Kidney
Recurrence
Naphazoline
Disease-Free Survival
Registries
Histology

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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Percutaneous Cryoablation of Solitary, Sporadic Renal Cell Carcinoma : Outcome Analysis Based on Clear-Cell versus Papillary Subtypes. / Haddad, Mustafa M.; Schmit, Grant D.; Kurup, A. Nicholas; Schmitz, John J.; Boorjian, Stephen A.; Geske, Jennifer; Thompson, R. Houston; Callstrom, Matthew R; Atwell, Thomas D.

In: Journal of Vascular and Interventional Radiology, 01.01.2018.

Research output: Contribution to journalArticle

Haddad, Mustafa M. ; Schmit, Grant D. ; Kurup, A. Nicholas ; Schmitz, John J. ; Boorjian, Stephen A. ; Geske, Jennifer ; Thompson, R. Houston ; Callstrom, Matthew R ; Atwell, Thomas D. / Percutaneous Cryoablation of Solitary, Sporadic Renal Cell Carcinoma : Outcome Analysis Based on Clear-Cell versus Papillary Subtypes. In: Journal of Vascular and Interventional Radiology. 2018.
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title = "Percutaneous Cryoablation of Solitary, Sporadic Renal Cell Carcinoma: Outcome Analysis Based on Clear-Cell versus Papillary Subtypes",
abstract = "Purpose: To evaluate treatment outcomes with percutaneous cryoablation (PCA) based on renal cell carcinoma (RCC) histology. Methods and Materials: Patients treated with PCA for a solitary, sporadic stage T1a RCC from 2003 to 2016 were identified from a single institution's renal ablation registry. Patients with multiple tumors, history of RCC, or genetic syndromes associated with RCC (n = 60); no specific RCC subtype determined from core biopsy (n = 66); RCC subtype other than clear-cell or papillary (n = 7); or less than 3 mo of follow-up imaging (n = 5) were excluded. In total, 173 patients met study inclusion criteria. Oncologic outcomes, clinical outcomes, and complications were evaluated based on tumor subtype. Results: Of the 173 patients who underwent PCA for a stage T1a RCC, 130 (75{\%}) had clear-cell RCC (ccRCC) and 43 (25{\%}) had papillary RCC (pRCC). Median tumor size was 2.9 cm (range, 1.3–4.0 cm). Technically successful cryoablation was achieved in all 173 patients. Local tumor recurrence developed in 6 patients with ccRCC (4.6{\%}), new renal tumors developed in 1 patient (0.8{\%}), and metastatic RCC developed in 1 patient (0.8{\%}) who also had local tumor recurrence. No patients with pRCC showed local tumor recurrence, new renal tumors, or metastatic disease. The 5-year disease-free survival rate in patients with ccRCC was 88{\%}, compared with 100{\%} in patients with pRCC (P =.48). Nine patients (5.2{\%}), all with ccRCC, experienced major complications (P =.11). Conclusions: Percutaneous ablation is a viable treatment option for patients with clinical stage T1a pRCC and ccRCC. Percutaneous ablation may be a very favorable treatment strategy particularly for pRCC.",
author = "Haddad, {Mustafa M.} and Schmit, {Grant D.} and Kurup, {A. Nicholas} and Schmitz, {John J.} and Boorjian, {Stephen A.} and Jennifer Geske and Thompson, {R. Houston} and Callstrom, {Matthew R} and Atwell, {Thomas D.}",
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T1 - Percutaneous Cryoablation of Solitary, Sporadic Renal Cell Carcinoma

T2 - Outcome Analysis Based on Clear-Cell versus Papillary Subtypes

AU - Haddad, Mustafa M.

AU - Schmit, Grant D.

AU - Kurup, A. Nicholas

AU - Schmitz, John J.

AU - Boorjian, Stephen A.

AU - Geske, Jennifer

AU - Thompson, R. Houston

AU - Callstrom, Matthew R

AU - Atwell, Thomas D.

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Y1 - 2018/1/1

N2 - Purpose: To evaluate treatment outcomes with percutaneous cryoablation (PCA) based on renal cell carcinoma (RCC) histology. Methods and Materials: Patients treated with PCA for a solitary, sporadic stage T1a RCC from 2003 to 2016 were identified from a single institution's renal ablation registry. Patients with multiple tumors, history of RCC, or genetic syndromes associated with RCC (n = 60); no specific RCC subtype determined from core biopsy (n = 66); RCC subtype other than clear-cell or papillary (n = 7); or less than 3 mo of follow-up imaging (n = 5) were excluded. In total, 173 patients met study inclusion criteria. Oncologic outcomes, clinical outcomes, and complications were evaluated based on tumor subtype. Results: Of the 173 patients who underwent PCA for a stage T1a RCC, 130 (75%) had clear-cell RCC (ccRCC) and 43 (25%) had papillary RCC (pRCC). Median tumor size was 2.9 cm (range, 1.3–4.0 cm). Technically successful cryoablation was achieved in all 173 patients. Local tumor recurrence developed in 6 patients with ccRCC (4.6%), new renal tumors developed in 1 patient (0.8%), and metastatic RCC developed in 1 patient (0.8%) who also had local tumor recurrence. No patients with pRCC showed local tumor recurrence, new renal tumors, or metastatic disease. The 5-year disease-free survival rate in patients with ccRCC was 88%, compared with 100% in patients with pRCC (P =.48). Nine patients (5.2%), all with ccRCC, experienced major complications (P =.11). Conclusions: Percutaneous ablation is a viable treatment option for patients with clinical stage T1a pRCC and ccRCC. Percutaneous ablation may be a very favorable treatment strategy particularly for pRCC.

AB - Purpose: To evaluate treatment outcomes with percutaneous cryoablation (PCA) based on renal cell carcinoma (RCC) histology. Methods and Materials: Patients treated with PCA for a solitary, sporadic stage T1a RCC from 2003 to 2016 were identified from a single institution's renal ablation registry. Patients with multiple tumors, history of RCC, or genetic syndromes associated with RCC (n = 60); no specific RCC subtype determined from core biopsy (n = 66); RCC subtype other than clear-cell or papillary (n = 7); or less than 3 mo of follow-up imaging (n = 5) were excluded. In total, 173 patients met study inclusion criteria. Oncologic outcomes, clinical outcomes, and complications were evaluated based on tumor subtype. Results: Of the 173 patients who underwent PCA for a stage T1a RCC, 130 (75%) had clear-cell RCC (ccRCC) and 43 (25%) had papillary RCC (pRCC). Median tumor size was 2.9 cm (range, 1.3–4.0 cm). Technically successful cryoablation was achieved in all 173 patients. Local tumor recurrence developed in 6 patients with ccRCC (4.6%), new renal tumors developed in 1 patient (0.8%), and metastatic RCC developed in 1 patient (0.8%) who also had local tumor recurrence. No patients with pRCC showed local tumor recurrence, new renal tumors, or metastatic disease. The 5-year disease-free survival rate in patients with ccRCC was 88%, compared with 100% in patients with pRCC (P =.48). Nine patients (5.2%), all with ccRCC, experienced major complications (P =.11). Conclusions: Percutaneous ablation is a viable treatment option for patients with clinical stage T1a pRCC and ccRCC. Percutaneous ablation may be a very favorable treatment strategy particularly for pRCC.

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