Safety, efficacy, and mid-term oncological outcomes of computed tomography-guided cryoablation of T1 renal cancer

Louise A Duus, Theresa Junker, Benjamin S Rasmussen, Jonas A Bojsen, Allan L Pedersen, Andrea Anthonsen, Lars Lund, Michael Pedersen, Ole Graumann

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BACKGROUND: Cryoablation is a promising minimally invasive, nephron-sparing treatment of small renal carcinoma (RCC) in co-morbid patients.

PURPOSE: To assess the safety, efficacy, and cancer-specific outcomes of computed tomography (CT)-guided cryoablation of stage T1 (RCC).

MATERIAL AND METHODS: A retrospective evaluation of 122 consecutive patients with 128 tumors treated with cryoablation during 2016-2017. All patients had biopsy-verified T1 RCC.

RESULTS: Median age was 69 years (IQR=59-76); 69% were male. Median tumor size was 26 mm (± 20-33); 9% were stage T1b. Mean follow-up time was 36.3±12.0 months. In total, 14 (11%) procedures led to complications, of which 4 (3%) were intraoperative, 5 (4%) appeared ≤30 days and 5 (4%) >30 days after treatment. Major complications arose after 4 (3%) procedures. Statistically significant associations were found between major complications and stage T1b (P = 0.039), RENAL score (P = 0.010), and number of needles used in cryoablation (P = 0.004). Residual tumor was detected after 4 (3%) procedures and 5 (4%) tumors had local tumor progression. Of 122 patients, 3 (2%) advanced to metastatic disease. Significant statistical associations were found between local tumor progression and T1b stage tumors and number of needles used in cryoablation (P = 0.05 and P = 0.004, respectively). For patients with T1a tumors, the one- and three-year disease-free survival was 98% and 95%, respectively, and for T1b 100% after one year and 75% after three years.

CONCLUSIONS: This study showed that cryoablation is a safe and effective treatment of stage T1 RCC and suggests that in selecting candidates for cryoablation of RCC, the tumor characteristics are more critical than patients' baseline health status.

TidsskriftActa Radiologica
Udgave nummer2
Sider (fra-til)814-820
StatusUdgivet - feb. 2023


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