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

Breen, D.J., Bryant, T., Abbas, A., Shepherd, B., McGill, N., Anderson, J., Lockyer, R., Hayes, M. and George, S. (2013) Percutaneous cryoablation of renal tumours: outcomes from 171 tumours in 147 patients. BJU International, 112, 758-765. (doi:10.1111/bju.12122). (PMID:23581293)

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.

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