Percutaneous and Laparoscopic Cryoablation of Small Renal Masses

Finley, David S.; Beck, Shawn; Box, Geoffrey N.; Wu, Chu; Deane, Leslie A.; Vajgrt, Duane; McDougall, Elspeth M.; Clayman, Ralph V.

doi:10.1016/j.juro.2008.04.019

Cited by 108 publications

(54 citation statements)

References 15 publications

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“…With the more recent introduction of thin probes used with argon systems, minimally invasive percutaneous cryoablation techniques are being utilized ( 34 , 35 ). In general, anteriorly located tumors may not be amenable to a percutaneous approach given their proximity to the bowel, although, in clinical practice, this is rarely an absolute contraindication ( 36 ).…”

Section: Essentialsmentioning

confidence: 99%

Percutaneous Ablation in the Kidney

Venkatesan¹,

Wood²,

Gervais³

2011

Radiology

107

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1Percutaneous ablation in the kidney is now performed as a standard therapeutic nephron-sparing option in patients who are poor candidates for resection. Its increasing use has been largely prompted by the rising incidental detection of renal cell carcinomas with cross-sectional imaging and the need to preserve renal function in patients with comorbid conditions, multiple renal cell carcinomas, and/or heritable renal cancer syndromes. Clinical studies to date indicate that radiofrequency ablation and cryoablation are effective therapies with acceptable short-to intermediateterm outcomes and with a low risk in the appropriate setting, with attention to pre-, peri-, and postprocedural detail. The results following percutaneous radiofrequency ablation and cryoablation in the treatment of renal cell carcinoma are reviewed in this article, including those of several larger scale studies of ablation of T1a tumors. Clinical and technical considerations unique to ablation in the kidney are presented, and potential complications are discussed.q RSNA, 2011

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Section: Essentialsmentioning

confidence: 99%

Percutaneous Ablation in the Kidney

Venkatesan¹,

Wood²,

Gervais³

2011

Radiology

107

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“…This outcome is comparable to published recurrence-free survival results, which ranged from 93.3% to 95.8%. 10,11 The major limitation with the published literature is the short follow-up, with most studies ranging from 6 to 24 months; there are limited published series with mean follow-up exceeding 3 years (Table 2). [12][13][14] A recent meta-analysis found the mean weighted follow-up of the published cryoablation literature to be 18.3 months.…”

Section: Discussionmentioning

confidence: 99%

“…The morbidity and costs may be lower with the percutaneous approach, 21,22 and in some institutions percutaneous renal cryoablation has become the preferred treatment modality for the asymptomatic small renal mass. 10 In most institutions, however, the techniques of laparoscopic and percutaneous cryoablation are complementary, with the percutaneous approach being used for posteriorly located tumours and the laparoscopic approach being used for the remainder. 23 Percutaneous cryoablation was not available in the early part of the study period at our institution; however, it is now part of our armamentarium.…”

Section: Discussionmentioning

confidence: 99%

Surgical cryoablation as an option for small renal masses in patients who are not ideal partial nephrectomy candidates: intermediate-term outcomes

Chalasani

Martínez

Lim

et al. 2013

CUAJ

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Objective: There has been increasing interest in surveillance and ablative techniques for small renal masses (SRM), given the increasing number being diagnosed at smaller sizes. Of the currently available ablative techniques, radiofrequency ablation and cryoablation have been the popular ones. We describe our intermediate-term outcomes with using cryoablation for SRM in patients who were not ideal candidates for partial nephrectomy. Recurrence-free survival (RFS) and overall survival (OS) were calculated using Kaplan Meier methodology. Results: The mean age was 56.7 years. The mean tumour size was 2.6 cm (range 1.2-4.0 cm). There were no intraoperative or postoperative complications in the 19 patients. One patient has been lost to follow-up; mean follow up was 41.6 months (range 7-84 months) in the cohort. Recurrence, defined as either increase in size of lesion or enhancement on follow-up imaging, was seen in 4 patients. There was 1 non-cancer specific death, and 1 cancer specific death. Conclusions:The 4-year RFS rate and OS rate were 83.6% and 94.1%, respectively, in patients with SRM who were unsuitable for partial nephrectomy.

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“…In such context, partial nephrectomies play an important role, with a bigger emphasis on LPN, which in dexterous hands has shown better results with respect to OPN in more recent studies [24]. Other therapies, such as active surveillance and ablative techniques, have also surfaced in the face of this new reality in the diagnosis of renal tumors [25,26].…”

Section: Discussionmentioning

confidence: 99%

Practice Trends in the Surgical Management of Renal Tumors in an Academic Medical Center in the Past Decade

et al. 2013

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Objectives. To evaluate the trends of surgical treatment of the renal tumor in an academic medical center. Methods. Between 2001 and 2010, 505 were treated surgically at the Federal University of Sao Paulo for renal tumors. The following variables were observed and analyzed according to their evolution through time: frequency and types of surgeries performed, operative time, hospital stay, and warm ischemia time for partial nephrectomy.Results. An increase in the frequency of laparoscopic radical nephrectomies, open partial nephrectomies, and laparoscopic partial nephrectomies was observed when comparing the periods from 2001 to 2005 (4.3%, 2.6%, and 12.6%, resp.) and from 2006 to 2010 (13.2%, 18.6%, and 20.2%, resp.; < 0.001). The average of operative time, hospital stay, and tumor size diminished (from 211.7 to 177.17 minutes, from 5.52 to 4.22 days, and from 6.72 to 5.29 cm, resp.) when compared to the periods from 2001 to 2005 and from 2006 to 2010 ( < 0.001, = 0.016, < 0.001, resp.). Conclusion. As time goes by, there has been a significant reduction in the hospital stay time, surgery time, and size of renal tumor in patients treated surgically. The frequencies of minimally invasive and nephron-sparing surgeries have increased over the last years.

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Percutaneous and Laparoscopic Cryoablation of Small Renal Masses

Cited by 108 publications

References 15 publications

Percutaneous Ablation in the Kidney

Percutaneous Ablation in the Kidney

Surgical cryoablation as an option for small renal masses in patients who are not ideal partial nephrectomy candidates: intermediate-term outcomes

Practice Trends in the Surgical Management of Renal Tumors in an Academic Medical Center in the Past Decade

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