Cryoablation of Renal Cancer: Variables Involved in Freezing-Induced Cell Death

Clarke, Dominic M.; Robilotto, Anthony T.; Rhee, Elisa; VanBuskirk, Robert G.; Baust, John G.; Gage, Andrew A.

doi:10.1177/153303460700600203

Cited by 64 publications

(60 citation statements)

References 40 publications

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“…16,[26][27][28] The PaCa response was similar to the À20 C isotherm reported for renal carcinoma. 36 For both prostate and renal cancer, decreasing levels of survival have been reported following exposure to À15…”

Section: Discussionmentioning

confidence: 99%

Characterization of Pancreatic Cancer Cell Thermal Response to Heat Ablation or Cryoablation

Baumann

Baust

Snyder

et al. 2016

Technol Cancer Res Treat

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One of the most lethal carcinomas is pancreatic cancer. As standard treatment using chemotherapy and radiation has shown limited success, thermal regimens (cryotherapy or heat ablation) are emerging as viable alternatives. Although promising, our understanding of pancreatic cancer response to thermal ablation remains limited. In this study, we investigated the thermal responses of 2 pancreatic cancer cell lines in an effort to identify the minimum lethal temperature needed for complete cell death to provide guidance for in vivo applications. PANC-1 and BxPC-3 were frozen (À10 C to À25 C) or heated (45 C-50 C) in single and repeated exposure regimes. Posttreatment survival and recovery were analyzed using alamarBlue assay over a 7-day interval. Modes of cell death were assessed using fluorescence microscopy (calcein acetoxymethyl ester/propidium iodide) and flow cytometry (YO-PRO-1/propidium iodide). Freezing to À10C resulted in minimal cell death. Exposure to À15 C had a mild impact on PANC-1 survival (93%), whereas BxPC-3 was more severely damaged (33%). Exposure to À20 C caused a significant reduction in viability (PANC-1 ¼ 23%; BxPC-3 ¼ 2%) whereas À25 C yielded complete death. Double freezing exposure was more effective than single exposure. Repeat exposure to À15 C resulted in complete death of BxPC-3, whereas À20 C severely impacted PANC-1 (7%). Heating to 45 C resulted in minimum cell death. Exposure to 48 C yielded a slight increase in cell loss (PANC-1 ¼ 85%; BxPC-3 ¼ 98%). Exposure to 50 C caused a significant decline (PANC-1 ¼ 70%; BxPC-3 ¼ 9%) with continued deterioration to 0%. Double heating to 45 C resulted in similar effects observed in single exposures, whereas repeated 48 C resulted in significant increases in cell death (PANC-1 ¼ 68%; BxPC-3 ¼ 29%). In conclusion, we observed that pancreatic cancer cells were completely destroyed at temperatures <À25 C or >50 C using single thermal exposures. Repeated exposures resulted in increased cell death at less extreme temperatures. Our data suggest that thermal ablation strategies (heat or cryoablation) may represent a viable technique for the treatment of pancreatic cancer.

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Section: Discussionmentioning

confidence: 99%

Characterization of Pancreatic Cancer Cell Thermal Response to Heat Ablation or Cryoablation

Baumann

Baust

Snyder

et al. 2016

Technol Cancer Res Treat

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“…However, the delayed effect resulting from damage to the microvasculature of the renal parenchyma is believed to be the most important mechanism of action of cryoablation [16]. Majority of times, the repeated cycles of freezing and thawing enhances tissue destruction, with some animal model experiments showing evidence that double freezing lead to large areas of tissue destruction compared to single freezing [17] …”

Section: Cryotherapymentioning

confidence: 99%

Ablative Therapy in 2016 for Small Renal Masses

Ian¹,

Farrag²,

Sriprasad³

2017

UNOAJ

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Introduction: Incidental diagnosis of small renal masses (SRMs), less than 4 cm in size, is increasing due to the widespread use of different forms of diagnostic imaging. The natural history of these tumours remains unknown and there is no reliable way to predict their behaviour or growth. Partial nephrectomy is currently the gold standard in the treatment of these tumours. However, the more minimally invasive, non-excisional, ablative therapies such as cryoablation (CRA) and radiofrequency ablation (RFA) are providing comparable oncological outcomes.Methods: This article critically reviews the principles, indications, modalities of treatment, oncological outcome, complication and effect on renal function, of the different ablative therapies.Results: Cryotherapy induces tissue ablation by freezing and thawing using argon and helium gases respectively.RFA ablates the tissue by heating. These Ablative treatments for SRMs are particularly indicated in the elderly patients, those with co-morbidities, in patients with solitary kidneys and in those with impaired renal function. The procedure related complication rate with ablative therapies are lower. These procedures have a promising medium term oncological outcome, while longer-term results are awaited. It appears that Cryotherapy may be evolving as a better modality for oncological control than RFA. Conclusion:The Ablative therapies for SRMs are emerging as viable treatment options with recurrence free survival rates approaching that of extirpative surgery. However, there is currently no consensus in the literature on the best selection criteria for this form of treatment. With further refinement of selection criteria and more prospective long-term data on the oncological outcome, these ablative methods would have a promising future in the management of SRMs.

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“…However, it is believed that the important mechanism of action of cryoablation is the delayed effect resulting from damaging the microvasculature of the renal parenchyma [16]. In the majority of the time, repeated cycles of freezing and thawing enhances tissue destruction with some evidence from animal model experiments showed that double freezing led to large areas of tissue destruction compared to single freezing [17]. During treatment, the temperature achieved is typically between −20 and −40°C or lower.…”

Section: Cryotherapymentioning

confidence: 99%

Non-Surgical Ablative Therapy for Management of Small Renal Masses—Current Status and Future Trends

Farrag

Sriprasad

2016

Indian J Surg Oncol

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A large number of small renal masses (SRMs) with size less than 4 cm are being identified due to advances in diagnostic imaging. As the natural history of these tumours remains unknown, there is no reliable way to predict their behaviour or future growth. Although, partial nephrectomy is the gold standard for treatment of these tumours, ablative non-surgical therapies such as cryoablation and radiofrequency ablation provide a less invasive option of treatment with comparable oncological outcomes. In this systematic review, the principle, indications, methods of treatment, oncological control, complication and renal function of ablative therapies are critically reviewed. Cryotherapy utilizes the principle of inducing tissue destruction by freezing and thawing using argon and helium gasses, respectively. Radiofrequency ablation (RFA) works on the principle of tissue heating. Ablative treatments are particularly useful in the elderly patients, those with comorbidities or in patients with SRMs in solitary kidneys or renal impairment. Ablative therapies have less procedurerelated complications and have promising medium-term oncological outcome. Longer-term results are accumulating. Cryotherapy may be a better modality for oncological control than RFA. Ablative therapy has emerged as a viable treatment options for SRMs with recurrence free survival rates approaching that of extirpative surgery. However, there is no consensus in the literature on the best selection criteria and this needs further refinement. Prospective long-term data with regards to oncological control is still needed

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Cryoablation of Renal Cancer: Variables Involved in Freezing-Induced Cell Death

Cited by 64 publications

References 40 publications

Characterization of Pancreatic Cancer Cell Thermal Response to Heat Ablation or Cryoablation

Characterization of Pancreatic Cancer Cell Thermal Response to Heat Ablation or Cryoablation

Ablative Therapy in 2016 for Small Renal Masses

Non-Surgical Ablative Therapy for Management of Small Renal Masses—Current Status and Future Trends

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