Percutaneous cryoablation of renal tumours: outcomes from 171 tumours in 147 patients

• Published in: BJU international 2013-10, Vol.112 (6), p.758-765
• Main Authors: Breen, David J., Bryant, Timothy J., Abbas, Ausami, Shepherd, Beth, McGill, Neil, Anderson, Jane A., Lockyer, Richard C., Hayes, Matthew C., George, Steve L.
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Biopsy; Carcinoma, Renal Cell - pathology; Carcinoma, Renal Cell - surgery; Cryosurgery - methods; Female; Follow-Up Studies; Humans; Incidence; Kidney Neoplasms - diagnosis; Kidney Neoplasms - mortality; Kidney Neoplasms - surgery; Kidneys; Male; Medical sciences; Neoplasm Recurrence, Local - epidemiology; Nephrology. Urinary tract diseases; percutaneous cryoablation; percutaneous image‐guided ablation; Prospective Studies; renal tumours; Studies; Surgery, Computer-Assisted - methods; Survival Rate - trends; Tomography, X-Ray Computed; Treatment Outcome; Tumors; Tumors of the urinary system; United Kingdom - epidemiology
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/bju.12122

Objective To evaluate the technical and oncological efficacy of an image‐guided cryoablation programme for renal tumours. Patients and Methods A prospective analysis of technical and radiological outcomes was undertaken after treatment of 171 consecutive tumours in 147 patients. Oncological efficacy in a subset of 125 tumours in 104 patients with >6 months' radiological follow‐up and a further subset of 62 patients with solitary, biopsy‐proven renal carcinoma was also analysed. Factors influencing technical success, as determined by imaging follow‐up, and complication rates were statistically analysed using a statistics software package and logistic regression analyses. Results No variables were found to predict subtotal treatment, although gender (P = 0.08), tumour size of >4 cm (P = 0.09) and central location of tumour (P = 0.07) approached significance. Upper pole location was the single variable that was found to predict complications (P = 0.006). Among the 104 patients (125 tumours), radiologically assessed at ≥6 months and with a mean radiological follow‐up of 20.1 months, we found a single case of unexpected late local recurrence. Conclusion Percutaneous image‐guided cryoablation, at a mean of 20.1 months' follow‐up, appears to provide a safe and effective treatment option with a low complication rate. Anteriorly sited tumours should not be considered a contraindication for percutaneous image‐guided cryoablation.