Percutaneous cryoablation of stage T1b renal cell carcinoma: Technique considerations, safety, and local tumor control

Thomas D. Atwell, Jay J. Vlaminck, Stephen A. Boorjian, Anil N. Kurup, Matthew R Callstrom, Adam J. Weisbrod, Christine M. Lohse, William R. Hartman, Andrew H. Stockland, Bradley C. Leibovich, Grant D. Schmit, Robert H. Thompson

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41 Scopus citations

Abstract

Purpose To describe the technical methods, safety, and local tumor control rate associated with percutaneous cryoablation of stage T1b renal cell carcinoma (RCC). Materials and Methods A retrospective review of a percutaneous renal ablation registry was used to identify 46 patients with a total of 46 biopsy-proven RCC lesions measuring 4.1-7.0 cm treated with cryoablation between 2003 and 2011. The main outcome parameters investigated were adjunctive maneuvers, complications, and local tumor progression, and cancer-specific survival rates. Complication rates were categorized and recorded using the Clavien-Dindo classification system. Progression-free and cancer-specific survival rates were estimated using the Kaplan-Meier method. Results The mean treated RCC size was 4.8 cm (range, 4.1-6.4 cm). Prophylactic tumor embolization was performed in 7 patients (15%), ipsilateral ureteral stents were placed in 7 patients (15%), and hydrodisplacement of bowel was performed in the treatment of 16 tumors (35%). A single technical failure (2.2%) was observed at the time of ablation. Thirty-six tumors (78%) had follow-up imaging at 3 months or later following ablation, including a single recurrence at 9 months after ablation. The mean duration of follow-up for the 35 RCC tumors that did not recur was 2.0 years (range, 0.3-6.1 y). Estimated local progression-free survival rate at 3 years was 96.4%. Of the 46 cryoablation procedures, there were 7 complications (15.2%) of grade II or worse. Conclusions The results suggest that cryoablation represents a valid treatment alternative for select patients with clinical stage T1b RCC. Complications are frequent enough that multidisciplinary patient management should be considered.

Original languageEnglish (US)
Pages (from-to)792-799
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume26
Issue number6
DOIs
StatePublished - Jun 1 2015

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Atwell, T. D., Vlaminck, J. J., Boorjian, S. A., Kurup, A. N., Callstrom, M. R., Weisbrod, A. J., Lohse, C. M., Hartman, W. R., Stockland, A. H., Leibovich, B. C., Schmit, G. D., & Thompson, R. H. (2015). Percutaneous cryoablation of stage T1b renal cell carcinoma: Technique considerations, safety, and local tumor control. Journal of Vascular and Interventional Radiology, 26(6), 792-799. https://doi.org/10.1016/j.jvir.2015.02.010