Percutaneous Cryoablation An Option for Renal Tumors

Percutaneous cryoablation may provide a safe and effective treatment option for patients with renal tumors, new findings suggest.

David J. Breen, MD, and colleagues from University Hospitals of Southampton NHS Foundation Trust in Southampton, U.K., analyzed technical and radiologic outcomes after treatment of 171 renal tumors in 147 patients. A total of 153 cryoablation procedures were performed. One patient with a single tumor was excluded from the analysis of technical success because the tumor was not evaluable.

The researchers identified no variables that significantly predicted primary subtotal treatment. Of the remaining 170 patients, 157 (92.4%) had their tumors treated successfully in a single session, according to a report published online ahead of print in BJU International. Another nine tumors were treated successfully after repeat cryoablation, for an overall technical success rate of 97.6%.

Additionally, the researchers analyzed oncologic efficacy in a subset of 125 tumors—of which 62 were documented solitary renal cell carcinomas (RCCs) and 10 were multi-tumor RCCs—in 104 patients who had at least six months of radiologic follow-up. Of the 104 patients, Dr. Breen's group observed only one case of unexpected late local recurrence after a mean follow-up of 20.1 months.

Three quarters of the tumors were 4 cm or smaller and the remaining tumors were 4-7 cm. An upper pole location of a tumor was the sole variable that predicted complications, according to the investigators. Complications occurred in 16 of the 153 treatment procedure sessions. Seven of these complications met or exceeded Clavien-Dindo grade 2 criteria (three pelvicalyceal injury, one post-procedure hemorrhage, one perirenal hematoma, and two pneumothorax requiring chest drain insertion).

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