Repeated Cryoablation as Treatment Modality After Failure of Primary Renal Cryoablation: A European Registry for Renal Cryoablation Multinational Analysis

J Endourol. 2019 Nov;33(11):909-913. doi: 10.1089/end.2019.0444.


Objectives: To assess the oncological outcome of recryoablation following failure of primary cryoablation in patients with small renal masses (SRMs). Materials and Methods: A retrospective review of 72 patients with a single renal tumor who failed primary laparoscopy-assisted cryoablation (LCA). All patients were initially treated with LCA at one of three European centers during a 12-year period. Results: A total of 38 patients (53%) were successfully salvaged with reablation(s) following treatment failure after primary LCA, having a median follow-up time of 28 (95% CI 19-105) months. Patients who failed recryoablation with additional cryoablation (n = 11), active surveillance (n = 11), oncological treatment (n = 7), partial nephrectomy/nephrectomy (n = 5), and follow-up terminated according to patient request (n = 4). The disease-free survival was significantly higher for patients retreated with CT-guided cryoablation compared with other cryoablative modalities (57% vs 31%, p = 0.046). Conclusion: Recryoablation following failure of primary cryoablation appears to have a significantly lower success rate compared with what is well known from primary cryoablation of SRM, but does not carry and increase risk of metastatic progression. CT-guided recryoablation appears to be superior to laparoscopy-assisted or ultrasonography recryoablation.

Keywords: locally recurrent renal cell carcinoma; recryoablation; retreatment; salvage treatment; small renal masses; treatment failure.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carcinoma, Renal Cell / surgery*
  • Cryosurgery / methods*
  • Disease Progression
  • Disease-Free Survival
  • Europe
  • Female
  • Humans
  • Kidney / surgery
  • Kidney Neoplasms / surgery*
  • Laparoscopy
  • Male
  • Middle Aged
  • Nephrectomy
  • Registries
  • Reoperation
  • Retrospective Studies
  • Salvage Therapy
  • Surgery, Computer-Assisted
  • Tomography, X-Ray Computed
  • Treatment Failure
  • Treatment Outcome
  • Ultrasonography