Safety and Efficacy of Percutaneous Image-guided Cryoablation of Completely Endophytic Renal Masses

Murray, Catherine; Welch, Brian T.; Schmit, Grant D.; Schmitz, John J.; Weisbrod, Adam J.; Callstrom, Matthew R.; Welch, Tasha L.; Thompson, R. Houston; Kurup, A. Nicholas; Boorjian, Stephen A.; Atwell, Thomas D.

doi:10.1016/j.urology.2019.08.005

Cited by 18 publications

(15 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Major complications occurred in 20% of procedures in the current study, which exceeds the typical complication rates reported in ablation of smaller renal tumors of approximately 10% [17,18]. The incidence of major hemorrhage was as low as 3.5% in a seven-year prospective study of 261 renal cryoablations by Kakarala and colleagues, although tumors in their cohort did not exceed 7 cm in size and required a median of 2.8 cryoprobes [19].…”

Section: Discussioncontrasting

confidence: 49%

Percutaneous Cryoablation of Large Tumors: Safety, Feasibility, and Technical Considerations

Parvinian

Kurup

Atwell

et al. 2021

Cardiovasc Intervent Radiol

Self Cite

View full text Add to dashboard Cite

Introduction Large tumors may prove unsuitable for surgical cure or other local therapies due to their size, involvement of critical structures, prior non-ablative treatment failure, or coexisting disease burden. This study was performed to assess the safety and feasibility of percutaneous cryoablation for treatment of large tumors exceeding 6 cm in size, and to highlight the key technical considerations inherent to such cases. Materials and Methods This single-institution retrospective study identified 77 patients (42 male, 35 female; median age 55 years) who underwent 96 cryoablation procedures for treatment of 78 tumors (mean diameter 9.8 ± 3.6 cm) from 2008 through 2020. Technical success, procedure-related complications, mortality, oncologic outcomes, and procedural logistics were evaluated. Technical success was defined as ice ball extension at least 5 mm beyond the tumor margins.Results Intentional subtotal ablations were performed in 32% of cases due to tumor encroachment on vulnerable structures or as part of staged/combined therapies. Of the 68% of cases that were planned for complete ablation, the technical success rate was 100%. Major complications occurred after 19/96 (20%) procedures, with hemorrhage and acute kidney injury each occurring in 6/96 (6%). Postprocedural myositis occurred in 24/96 (25%) cases and was not considered a major complication in the absence of acute kidney injury. Local recurrence occurred in 2/23 (8.7%) of patients undergoing ablation for cure or local control at a median follow-up duration of 13 months. Conclusion Percutaneous cryoablation may be used to treat large ([ 6 cm) tumors with a high degree of technical success and an acceptable safety profile.

show abstract

Section: Discussioncontrasting

confidence: 49%

Percutaneous Cryoablation of Large Tumors: Safety, Feasibility, and Technical Considerations

Parvinian

Kurup

Atwell

et al. 2021

Cardiovasc Intervent Radiol

Self Cite

View full text Add to dashboard Cite

show abstract

“…T 1b renal cell carcinoma patients who underwent partial nephrectomy also had a lower rate of local cancer recurrence than patients with cryoablation (laparoscopic or percutaneous) 59 . Further, cryoablation of T 1b renal cell carcinomas caused frequent complications (grade II or worse) 37 , although fewer complications were seen in completely endophytic masses 60 . To reduce the rate of complications, several techniques such as hydro-, carbo-, and pneumo-dissection 61 , balloon dissection, and probe traction 62 have been proposed to minimize the impact of cryoablation on adjacent non-renal structures.…”

Section: Cryoablation For the Treatment Of Various Types Of Cancers I...mentioning

confidence: 96%

“…Image-guided cryoablation via multiple imaging modalities such as MRI 125 , 126 , CT 127 - 131 , PET 132 , and ultrasound (US) 133 is vital to the technical success of the procedure 60 . Images can be observed to guide the cryoprobe to the tumor, for real-time monitoring of ice growth, and be evaluated by the researchers post-cryoablation to assess for residual unablated tumor and complications.…”

Section: Image-guided Cryoablation Cancer Therapymentioning

confidence: 99%

Recent progress in cryoablation cancer therapy and nanoparticles mediated cryoablation

Kwak¹,

B²,

Lewandowski³

et al. 2022

Theranostics

View full text Add to dashboard Cite

With rapid advances in modern imaging, minimally invasive ablative procedures have emerged as popular alternatives to surgical removal of tumors. Tumor ablation modalities currently offered in clinical practice include microwave ablation, radiofrequency ablation, cryoablation, high-intensity focused ultrasound, and irreversible electroporation. Cryoablation, a non-heat-based method of ablation, is increasingly being used for treating various solid tumors. Accumulated comparative data of cryoablation versus heat-based ablation techniques (e.g., radiofrequency and microwave ablation) shows superior tumor response and quicker recovery time. Evolving research has demonstrated that nanocarriers may serves as excellent catalysts for the cryoablation therapy, imaging guidance, and the co-delivery of therapeutics for minimally invasive, precise, and complete treatment of cancer with immune modulation. This review article focuses on the current status of cryoablation in clinical practice, considers opportunities for enhancing therapeutic outcomes from cryoablation, and discusses new research in the field, including theranostic nanoparticles-mediated cryotherapy and combinational cryo-based immunotherapies.

show abstract

“…For T1a RCC, the local tumor control rate of partial nephrectomy was reported to be 95% to 100% [49,[57][58][59][60][61]. In contrast, with cryoablation and RF ablation, the local control rates of T1a RCC were reported as 76.8% to 100% [61][62][63][64] and 91% to 100% [49,57,61,62,64], respectively. Among larger RCC tumors, thermal ablation can also provide a good level of local control in selected patients: for T1b RCC, the local tumor control rate of partial nephrectomy was reported as 91% to 100% [60,61,65], while cryoablation and RF ablation had reported rates of 84% to 100% [19,53,60,61,65] and 91% [19], respectively.…”

Section: Oncologic Outcomesmentioning

confidence: 99%

“…An approximately 10% decrease in renal function has been reported after thermal ablation of T1 RCC tumors [19,23,62,63,65,68,73]. More specifically, the percentage decrease in renal function [i.e., glomerular filtration rate (GFR) or estimated GFR] after thermal ablation was reported to be 8% to 12% in patients with T1a RCC [49,59,73]; in patients with T1b RCC, the percentage decrease in renal function after thermal ablation was 7% to 27% [19,65].…”

Section: Change In Renal Functionmentioning

confidence: 99%

Percutaneous Image-guided Thermal Ablation for Renal Cell Carcinoma

Fujimori

Yamanaka

Sugino

et al. 2020

Interventional Radiology

View full text Add to dashboard Cite

Nephrectomy is the gold standard for the treatment of renal cell carcinoma (RCC). However, some patients are not suitable candidates for nephrectomy because of high surgical risk, reduced renal function, or the presence of multiple renal tumors. Percutaneous image-guided thermal ablation, including cryoablation and radiofrequency ablation, is a minimally invasive and highly effective treatment and can be used to treat RCC in patients who are not good candidates for surgery. This article will review percutaneous image-guided thermal ablation for RCC, covering treatment indications, ablation modalities and techniques, oncologic outcomes, and possible complications. In addition, the characteristics of each ablation modality and its comparison with nephrectomy are also presented.

show abstract

Safety and Efficacy of Percutaneous Image-guided Cryoablation of Completely Endophytic Renal Masses

Cited by 18 publications

References 15 publications

Percutaneous Cryoablation of Large Tumors: Safety, Feasibility, and Technical Considerations

Percutaneous Cryoablation of Large Tumors: Safety, Feasibility, and Technical Considerations

Recent progress in cryoablation cancer therapy and nanoparticles mediated cryoablation

Percutaneous Image-guided Thermal Ablation for Renal Cell Carcinoma

Contact Info

Product

Resources

About