Second Prize: Recurrence Rates After Percutaneous and Laparoscopic Renal Cryoablation of Small Renal Masses: Does the Approach Make a Difference?

Abstract

In this multicenter study of well-matched cohorts, PRC had higher primary treatment failure rates than TLRC. While no differences were noted between DFS and OS, analysis is limited by intermediate follow-up. Further study is necessary to discern reasons for the higher recurrence rates in PRC and to determine what long-term consequences exist.

Skin-to-tumor Distance Predicts Treatment Failure of T1A Renal Cell Carcinoma Following Percutaneous Cryoablation

“…Previous PN studies have demonstrated that tumor specific variables such as size, depth within the kidney, and tumor polarity and location relative to the renal hilum significantly impact outcomes including perioperative complications and oncological outcomes 11,12,22 .…”

“…Tumor and patient characteristics such as tumor size, location, depth, and patient body mass index (BMI) account for the complexity of a procedure and potentially lead to higher treatment failure and complication rates [11][12][13] . Current reports support the assertion that PCA should only be applied to T1a (<4cm) renal cell carcinoma variants, with early evidence corroborating that tumor size directly affects oncologic outcomes 14 .…”

“…Current reports support the assertion that PCA should only be applied to T1a (<4cm) renal cell carcinoma variants, with early evidence corroborating that tumor size directly affects oncologic outcomes 14 . Further, the location of the tumor such as anterior or upper pole lesions, may have significant impact on the difficulty of needle deployment and proper lesion targeting 12,15 . In addition, proximity of the tumor to hilar vessels, has also been hypothesized to contribute to treatment failure due to the possibility of "heat sink", or the inability for the juxtavascular probe to reach temperatures low enough to induce complete tumor necrosis 11,12,14 .…”

“…Further, the location of the tumor such as anterior or upper pole lesions, may have significant impact on the difficulty of needle deployment and proper lesion targeting 12,15 . In addition, proximity of the tumor to hilar vessels, has also been hypothesized to contribute to treatment failure due to the possibility of "heat sink", or the inability for the juxtavascular probe to reach temperatures low enough to induce complete tumor necrosis 11,12,14 . Treatment algorithms that take into account the size, location, and proximity to surrounding retroperitoneal and abdominal structures have been developed that are predictive of treatment difficulty and complications, however, few studies combining patient and tumor specific variables to predict long-term procedural outcomes have been conducted 16 .…”

Efficacy of percutaneous cryoablation of renal cell carcinoma in older patients with medical comorbidities: Outcome study in 70 patients

“…5,7,[12][13][14][15][16][17] The number of cryoprobes (2.4 and 3 mm, 4-cm freeze length, various shaft length, Endocare, Perc 24 system, Heathronics, Austin, TX) was determined by size, geometry, and morphology of the tumour to adequately cover the lesion with the resulting iceball. The probes were placed under CT guidance (contrast enhanced and 3D volume reconstruction) 1 to 1.5 cm apart, in a pattern akin to a radiation therapy implant, resulting in a freezing zone covering the lesion plus a 5-mm margin.…”