Percutaneous cryoablation of renal masses: Washington University experience of treating 129 tumours

What's known on the subject? and What does the study add? For patients who are unfit for extirpative surgery, percutaneous cryoablation (PCA) presents a minimally‐invasive alternative for the treatment of renal masses. PCA has been demonstrated to be safe, with complication rates 20 months, tre...

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Bibliographic Details
Published in:BJU international 2013-05, Vol.111 (6), p.872-879
Main Authors: Kim, Eric H., Tanagho, Youssef S., Bhayani, Sam B., Saad, Nael E., Benway, Brian M., Figenshau, R. Sherburne
Format: Article
Language:English
Subjects:
Age Factors
Aged
Carcinoma, Renal Cell - epidemiology
Carcinoma, Renal Cell - pathology
Carcinoma, Renal Cell - physiopathology
Carcinoma, Renal Cell - surgery
Clinical outcomes
cryosurgery
Cryosurgery - methods
Female
Follow-Up Studies
Glomerular Filtration Rate
Hospitals, University
Humans
kidney
Kidney diseases
Kidney Neoplasms - epidemiology
Kidney Neoplasms - pathology
Kidney Neoplasms - physiopathology
Kidney Neoplasms - surgery
Laparoscopy
Length of Stay - statistics & numerical data
Male
minimally‐invasive surgical procedures
Multivariate Analysis
Nephrectomy - methods
percutaneous catheter ablation
RCC
Retrospective Studies
Risk Assessment
Risk Factors
Studies
Success
Surgery
Treatment Outcome
Tumors
Washington - epidemiology
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Summary:What's known on the subject? and What does the study add? For patients who are unfit for extirpative surgery, percutaneous cryoablation (PCA) presents a minimally‐invasive alternative for the treatment of renal masses. PCA has been demonstrated to be safe, with complication rates 20 months, treatment success rates range from 75% to 96%. However, longer‐term oncological and functional results for patients treated with PCA are relatively limited. The present study profiles one of the largest reported experiences with PCA for renal masses: 129 tumours in 124 patients. Our complication rate was comparable to that observed in other reported studies. At a mean follow‐up of 30 months, treatment success was achieved in 87% of tumours, which is in line with published PCA success rates. On multivariable analysis, tumour size >3.0 cm was found to be significantly associated with treatment failure. A minimal but statistically significant renal functional decline was observed, with 20% of patients experiencing a progression in National Kidney Foundation‐Chronic Kidney Disease stage. On multivariable analysis, age >70 years, hilar tumour location and postoperative day 1 estimated glomerular filtration rate
ISSN:1464-4096
1464-410X
DOI:10.1111/j.1464-410X.2012.11432.x