Percutaneous cryoablation of localized T1a renal cell carcinoma (RCC) provides good, long-term oncologic control with a low rate of complications, according to a podium presentation at the American Urological Association’s 2023 Annual Meeting in Chicago, Illinois.

At 5 years after percutaneous cryoablation for RCC, the overall survival rate was 87%, the cancer-specific survival rate was 100%, and the recurrence-free survival rate was 88% among patients without residual disease, Taigo Kato, MD, PhD, of Osaka University in Japan, reported.

Of the 97 patients studied, 71 received computed tomography (CT)-guided percutaneous cryoablation as initial therapy and 26 as treatment for local recurrence of small RCC. Of the cohort, 45% had ECOG performance status of 1-4, 27% had an ASA Physical Status score of III, and 49% had comorbidities.

According to biopsy results at 3 months after cryoablation in 88 patients, 2 patients had residual cancer and 6 patients experienced recurrence. The rate of severe Grade 3 complications was 2.0%.

In an immunohistochemistry analysis following cryoablation in 22 patients, the investigators confirmed a significant increase in CD8 T and CD11c cells infiltrating renal tissues, which may play a role in controlling tumor progression.

With respect to nephron-sparing, mean estimated glomerular filtration rate (eGFR; in mL/min/1.73 m²) declined from 52.8 at baseline to 48.3 at 3 months after cryoablation, then stabilized. A logistic regression analysis showed that greater tumor complexity, indicated by a R.E.N.A.L nephrometry score greater than 7 (vs less than 7), was significantly associated with 3.0-fold increased odds of a more than 20% decline in eGFR.

Although patients receiving percutaneous ablation were more likely to have poor performance status and medical history, they achieved promising oncologic outcomes and relatively stable renal function, Dr Kato summarized.

“Percutaneous ablation appears to be a reasonable option for patients with high comorbidity at presentation,” Dr Kato said.

He added, “Our findings revealed that cryoablation could induce strong immune reactions in tumors with oligoclonal expansion of antitumor T cells, which circulate systemically.”

Reference

Kato T, Okuda Y, Ono Y, et al. Clinical outcomes and immune response of percutaneous cryoablation for localized renal cell carcinoma: experience in clinical practice in Japan. Presented at: AUA 2023, Chicago, Illinois, April 28-May 1. Presentation PD07-08.

This article originally appeared on Renal and Urology News

Percutaneous cryoablation of localized T1a renal cell carcinoma (RCC) provides good, long-term oncologic control with a low rate of complications, according to a podium presentation at the American Urological Association’s 2023 Annual Meeting in Chicago, Illinois.

At 5 years after percutaneous cryoablation for RCC, the overall survival rate was 87%, the cancer-specific survival rate was 100%, and the recurrence-free survival rate was 88% among patients without residual disease, Taigo Kato, MD, PhD, of Osaka University in Japan, reported.

Of the 97 patients studied, 71 received computed tomography (CT)-guided percutaneous cryoablation as initial therapy and 26 as treatment for local recurrence of small RCC. Of the cohort, 45% had ECOG performance status of 1-4, 27% had an ASA Physical Status score of III, and 49% had comorbidities.

According to biopsy results at 3 months after cryoablation in 88 patients, 2 patients had residual cancer and 6 patients experienced recurrence. The rate of severe Grade 3 complications was 2.0%.

In an immunohistochemistry analysis following cryoablation in 22 patients, the investigators confirmed a significant increase in CD8 T and CD11c cells infiltrating renal tissues, which may play a role in controlling tumor progression.

With respect to nephron-sparing, mean estimated glomerular filtration rate (eGFR; in mL/min/1.73 m²) declined from 52.8 at baseline to 48.3 at 3 months after cryoablation, then stabilized. A logistic regression analysis showed that greater tumor complexity, indicated by a R.E.N.A.L nephrometry score greater than 7 (vs less than 7), was significantly associated with 3.0-fold increased odds of a more than 20% decline in eGFR.

Although patients receiving percutaneous ablation were more likely to have poor performance status and medical history, they achieved promising oncologic outcomes and relatively stable renal function, Dr Kato summarized.

“Percutaneous ablation appears to be a reasonable option for patients with high comorbidity at presentation,” Dr Kato said.

He added, “Our findings revealed that cryoablation could induce strong immune reactions in tumors with oligoclonal expansion of antitumor T cells, which circulate systemically.”

Reference

Kato T, Okuda Y, Ono Y, et al. Clinical outcomes and immune response of percutaneous cryoablation for localized renal cell carcinoma: experience in clinical practice in Japan. Presented at: AUA 2023, Chicago, Illinois, April 28-May 1. Presentation PD07-08.

This article originally appeared on Renal and Urology News