Percutaneous Cryoablation of Stage T1b Renal Cell Carcinoma: Safety, Technical Results, and Clinical Outcomes

Gunn, Andrew J.; Joe, Winston B; Salei, Aliaksei; Khudari, Husameddin El; Mahmoud, Khalid; Bready, Eric; Keasler, Eric; Patten, P.; Gordetsky, Jennifer B.; Rais‐Bahrami, Soroush; Aal, Ahmed Kamel Abdel

doi:10.1007/s00270-019-02226-5

Cited by 30 publications

(30 citation statements)

References 32 publications

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“…Primary efficacy rates between 75 and 100% were reported in 12 and 7 T1b tumours, respectively [12,33]. In the literature, CA is more commonly used as ablation technique for T1b lesions with primary efficacy rates ranging from 76 to 97.2% [2,5,13,15]. Our results show that MWA can also be used and chosen as a treatment modality in T1b tumours with consideration of a second ablation.…”

Section: Discussionmentioning

confidence: 54%

Percutaneous Microwave Ablation of Histologically Proven T1 Renal Cell Carcinoma

Aarts

Prevoo

Meier

et al. 2020

Cardiovasc Intervent Radiol

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Objectives To assess the safety and efficacy of percutaneous microwave ablation (MWA) of histologically proven T1 renal cell carcinoma (RCC). Methods We analysed patients with a histologically proven RCC (B 7 cm) treated by MWA from April 2012-April 2018. Primary and secondary efficacy, local tumour recurrence (LTR), morbidity and mortality were reported. Efficacy was defined as no residual tumour enhancement on follow-up imaging 1 month after the first ablation (primary efficacy) and after re-ablation(s) for residual disease (secondary efficacy). Adverse events (AE) were registered by the Clavien-Dindo classification and the common terminology criteria for AE. Univariable and multivariable logistic regression analyses were performed to investigate a relation among pre-treatment factors incomplete ablation and complications. Results In 100 patients, a total of 108 RCCs (85 T1a and 23 T1b) were treated by MWA. Median size was 3.2 cm (IQR 2.4-4.0). Primary efficacy was 89% (95%CI 0.81-0.94) for T1a lesions and 52% (95%CI 0.31-0.73) for T1b lesions (p \ 0.001). Fifteen lesions (7 T1a) were reablated for residual disease by MWA in one (n = 13) and two (n = 2, both T1b) sessions resulting in secondary efficacy rates of 99% (T1a) and 95% (T1b, p = 0.352). LTR occurred in four tumours (2 T1a, 2 T1b) after 10-60 months. Six (4%) AEs grade [ 3-5 were observed (2 T1a, 4 T1b, p = 0.045). Multivariable analysis showed that mR.E.N.A.L. nephrometry was independently associated with incomplete ablation (p = 0.012). Conclusion Microwave ablation is safe and effective for T1a and T1b RCC lesions with a significantly lower primary efficacy for T1b lesions.

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Section: Discussionmentioning

confidence: 54%

Percutaneous Microwave Ablation of Histologically Proven T1 Renal Cell Carcinoma

Aarts

Prevoo

Meier

et al. 2020

Cardiovasc Intervent Radiol

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“…Hasegawa et al evaluated 23 patients treated by cryoablation for T1b RCC and found a mean eGFR loss of 7.6 ml/min/ 1.73m 2 at 1 month after treatment [4]. Gunn et al [10] evaluated 37 patients treated by cryoablation for T1b RCC and found no significant change in renal function after cryoablation (p > .05). Patients with central RCC had poorer functional outcomes after cryoablation (mean D À14.6 ml/min/1.73m 2 ), possibly caused by functional impairment of healthy renal parenchyma and sinus within the ablation area.…”

Section: Discussionmentioning

confidence: 99%

“…Although technical efficacy was based on a 3-months follow-up imaging, a 1-month imaging was systematically performed. First, it allowed to ensure the absence of delayed complication described after cryoablation [10] (abscess, pseudo-aneurysm, ureteral stenosis, fistula). Then, it allows early detection of residual unablated tumor, and, if there was any, to anticipate repeat cryoablation.…”

Section: Discussionmentioning

confidence: 99%

“…A recent study showed similar recurrence-free survival outcomes for PN and cryoablation for sporadic cT1b renal tumors (4-7 cm) [8]. However, few studies of cryoablation for cT1b tumors are available [9][10][11]. Atwell et al evaluated percutaneous cryoablation of 46 T1b renal tumors, with 15.2% of major complications, and 96.4% progression-free survival at 1-, 3and 5-year follow-up.…”

Section: Introductionmentioning

confidence: 99%

“…Hebbadj et al [9] evaluated percutaneous cryoablation of 27 T1b renal tumors, with 95.7% of cancer specific survival at 12-24-and 36-month follow-up. A recent study of Gunn et al [10] evaluated 37 renal cell carcinoma (RCC), with 100, 86.1 and 62.6% of recurrencefree survival at 1-2-and 3-year follow-up. The present study evaluated the oncologic efficacy, safety, and functional outcome of percutaneous CT-guided cryoablation for renal cT1b tumors.…”

Section: Introductionmentioning

confidence: 99%

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Computed tomography-guided percutaneous cryoablation of T1b renal tumors: safety, functional and oncological outcomes

Grange

Tradi

Izaaryene

et al. 2019

International Journal of Hyperthermia

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Purpose: To evaluate the safety, functional and oncological outcomes associated with percutaneous cryoablation of stage T1b renal cell carcinoma (RCC). Materials and methods: Institutional database was reviewed to identify patients treated by percutaneous CT-guidance cryoablation between 2013 and 2018 for biopsy-proven RCC tumors measuring 4.1-7.0 cm. The main outcome parameters analyzed were primary and secondary technique efficacy, progression-free survival (PFS), cancer-specific survival (CSS), loss of estimated glomerular filtration rate (eGFR) and complications. PFS and CSS were estimated by the Kaplan-Meier method. Complications were graded by the Clavien-Dindo system. Results: Twenty-three consecutive patients were included (mean tumor diameter: 45.6 ± 6.2 mm; mean RENAL score: 8.1 ± 1.8). The technical success rate was 95.7%. Primary and secondary technique efficacy rates were 86.3 and 100%, respectively. Three patients found to have incomplete ablations at 3 months were successfully treated by repeat cryoablation. Median duration follow-up was 11 months (range: 3-33). Imaging showed PFS to be 85.7% at 6 months, 66.7% at 12 months and 66.7% at 24 months. One patient with a local recurrence at 12 months was treated by radical nephrectomy. One patient died from progression of disease within 12 months. One patient reported a complication grade ! II (4.3%). Mean eGFR loss was 4.4 ± 8.5 ml/min/1.73m 2 , which was significantly higher among those treated for central tumors (p < .05). Conclusion: Cryoablation for stage T1b renal tumors is technically feasible, with favorable oncological and perioperative outcomes. Longer-term studies are needed to verify our findings. ARTICLE HISTORY

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Percutaneous cryoablation of 100 anterior renal tumors: safety and technical success

Raja,

Pigg,

et al. 2023

Abdom Radiol

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Percutaneous Cryoablation of Stage T1b Renal Cell Carcinoma: Safety, Technical Results, and Clinical Outcomes

Cited by 30 publications

References 32 publications

Percutaneous Microwave Ablation of Histologically Proven T1 Renal Cell Carcinoma

Percutaneous Microwave Ablation of Histologically Proven T1 Renal Cell Carcinoma

Computed tomography-guided percutaneous cryoablation of T1b renal tumors: safety, functional and oncological outcomes

Percutaneous cryoablation of 100 anterior renal tumors: safety and technical success

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