Percutaneous Image-Guided Cryoablation of Endophytic Renal Cell Carcinoma

Christian Greve Jensen, Marco Dybdahl, John Valtersson, Bo Redder Mussmann, Louise Aarup Duus, Theresa Junker, Pia Iben Pietersen, Lars Lund, Brian T Welch, Ole Graumann*

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Abstract

PURPOSE: Endophytic renal cancer treatment is a challenge. Due to difficulties in endophytic tumor visualization during surgical extirpation, image-guided percutaneous cryoablation (PCA) is an attractive alternative. The minimally invasive nature of PCA makes it favorable for comorbid patients as well as patients in which surgery is contraindicated. Oncological outcomes and complications after PCA of endophytic biopsy-proven renal cell carcinoma (RCC) were reviewed in this study.

MATERIALS AND METHODS: Patients were included after a multidisciplinary team conference from January 2015 to November 2021. Inclusion criteria were endophytic biopsy-proven T1 RCC treated with PCA with one year of follow-up. Complications were reported according to the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) classification system and the Clavien-Dindo classification (CDC) system. Major complications were defined as a grade ≥ 3 according to the CDC.

RESULTS: Fifty-six patients were included with a total of 56 endophytic tumors treated during 61 PCA sessions. The median RENAL nephrometry score was 9 (IQR 2), and the mean tumor size was 25.7 mm (SD ± 8.9 mm). Mean hospitalization time was 0.39 (SD ± 1.1) days. At a mean follow-up of 996 days (SD ± 559), 86% of tumors were recurrence free after one PCA. No patients progressed to metastatic disease. According to the CIRSE classification, 10.7% (n = 6) had grade 3 complications, and 5.4% (n = 3) had CDC major complications.

CONCLUSION: This study demonstrates that PCA of endophytic biopsy-proven T1 RCC is safe with few major complications and excellent local tumor control rates at almost three-year mean follow-up. LEVEL OF EVIDENCE 3: Retrospective cohort study.

Original languageEnglish
JournalCardiovascular and Interventional Radiology
Volume47
Issue number4
Pages (from-to)453-461
ISSN0174-1551
DOIs
Publication statusPublished - Apr 2024

Keywords

  • Ablation
  • Cryoablation
  • Endophytic tumor
  • PCA
  • Percutaneous
  • RCC
  • Renal cancer
  • Cryosurgery
  • Carcinoma, Renal Cell/diagnostic imaging
  • Humans
  • Treatment Outcome
  • Kidney Neoplasms/diagnostic imaging
  • Retrospective Studies
  • Kidney/pathology

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