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Percutaneous Cryoablation of Stage T1b Renal Cell Carcinoma: Technique Considerations, Safety, and Local Tumor Control
Ist Teil von
Journal of vascular and interventional radiology, 2015-06, Vol.26 (6), p.792-799
Ort / Verlag
United States: Elsevier Inc
Erscheinungsjahr
2015
Quelle
MEDLINE
Beschreibungen/Notizen
Abstract Purpose To describe the technical methods, safety, and local tumor control rate associated with percutaneous cryoablation of stage T1b renal cell carcinoma (RCC). Materials and Methods A retrospective review of a percutaneous renal ablation registry was used to identify 46 patients with a total of 46 biopsy-proven RCC lesions measuring 4.1–7.0 cm treated with cryoablation between 2003 and 2011. The main outcome parameters investigated were adjunctive maneuvers, complications, and local tumor progression, and cancer-specific survival rates. Complication rates were categorized and recorded using the Clavien–Dindo classification system. Progression-free and cancer-specific survival rates were estimated using the Kaplan–Meier method. Results The mean treated RCC size was 4.8 cm (range, 4.1–6.4 cm). Prophylactic tumor embolization was performed in 7 patients (15%), ipsilateral ureteral stents were placed in 7 patients (15%), and hydrodisplacement of bowel was performed in the treatment of 16 tumors (35%). A single technical failure (2.2%) was observed at the time of ablation. Thirty-six tumors (78%) had follow-up imaging at 3 months or later following ablation, including a single recurrence at 9 months after ablation. The mean duration of follow-up for the 35 RCC tumors that did not recur was 2.0 years (range, 0.3–6.1 y). Estimated local progression-free survival rate at 3 years was 96.4%. Of the 46 cryoablation procedures, there were 7 complications (15.2%) of grade II or worse. Conclusions The results suggest that cryoablation represents a valid treatment alternative for select patients with clinical stage T1b RCC. Complications are frequent enough that multidisciplinary patient management should be considered.