Percutaneous cryoablation of renal tumours: outcomes from 171 tumours in 147 patients

BJU Int. 2013 Oct;112(6):758-65. doi: 10.1111/bju.12122. Epub 2013 Apr 12.

Abstract

Objective: To evaluate the technical and oncological efficacy of an image-guided cryoablation programme for renal tumours.

Patients and methods: A prospective analysis of technical and radiological outcomes was undertaken after treatment of 171 consecutive tumours in 147 patients. Oncological efficacy in a subset of 125 tumours in 104 patients with >6 months' radiological follow-up and a further subset of 62 patients with solitary, biopsy-proven renal carcinoma was also analysed. Factors influencing technical success, as determined by imaging follow-up, and complication rates were statistically analysed using a statistics software package and logistic regression analyses.

Results: No variables were found to predict subtotal treatment, although gender (P = 0.08), tumour size of >4 cm (P = 0.09) and central location of tumour (P = 0.07) approached significance. Upper pole location was the single variable that was found to predict complications (P = 0.006). Among the 104 patients (125 tumours), radiologically assessed at ≥6 months and with a mean radiological follow-up of 20.1 months, we found a single case of unexpected late local recurrence.

Conclusion: Percutaneous image-guided cryoablation, at a mean of 20.1 months' follow-up, appears to provide a safe and effective treatment option with a low complication rate. Anteriorly sited tumours should not be considered a contraindication for percutaneous image-guided cryoablation.

Keywords: percutaneous cryoablation; percutaneous image-guided ablation; renal tumours.

MeSH terms

  • Aged
  • Biopsy
  • Carcinoma, Renal Cell / pathology
  • Carcinoma, Renal Cell / surgery*
  • Cryosurgery / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Kidney Neoplasms / diagnosis
  • Kidney Neoplasms / mortality
  • Kidney Neoplasms / surgery*
  • Male
  • Neoplasm Recurrence, Local / epidemiology
  • Prospective Studies
  • Surgery, Computer-Assisted / methods*
  • Survival Rate / trends
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • United Kingdom / epidemiology