Image-guided percutaneous cryoablation of T1b renal cell carcinomas in patients with comorbidities

Jpn J Radiol. 2021 Dec;39(12):1213-1222. doi: 10.1007/s11604-021-01168-8. Epub 2021 Jul 6.

Abstract

Purpose: To investigate the influence of comorbidities and tumor characteristics on outcomes following percutaneous cryoablation (PCA) of T1b renal cell carcinoma (RCC).

Materials and methods: Age-adjusted Charlson comorbidity index (ACCI); standardized system for quantitating renal tumor size, location, and depth (RENAL nephrometry score [RNS]); and local tumor control and survival were retrospectively investigated in 28 patients who underwent PCA for stage T1b RCC. Risk factors for elevated serum creatinine levels were also investigated.

Results: Complete ablation was obtained in 27 of 28 patients. Two cases of metastasis were observed; one patient died 12 months after PCA. Overall survival at 5 years was 79.1%, with a mean follow-up of 42.0 ± 16.0 months. Local tumor control was not correlated with the ACCI and RNS. Worsening renal function 3 months after PCA was observed in ten patients, and it correlated with the presence of single kidneys (7/28 patients; p = 0.023). Significant worsening of renal function continued until 1 year after PCA (p = 0.013). Having a single kidney was a risk factor for worsened renal function after PCA (odds ratio, 8.00; 95% confidence interval 1.170-54.724).

Conclusion: PCA for T1b RCC confers positive local tumor control regardless of comorbidities and tumor characteristics.

Keywords: 5-year survival; Charlson comorbidity score; Percutaneous cryoablation; RENAL nephrometry score; T1b renal cell carcinoma.

MeSH terms

  • Carcinoma, Renal Cell* / diagnostic imaging
  • Carcinoma, Renal Cell* / surgery
  • Comorbidity
  • Cryosurgery*
  • Humans
  • Kidney Neoplasms* / diagnostic imaging
  • Kidney Neoplasms* / surgery
  • Retrospective Studies
  • Treatment Outcome