Percutaneous Cryoablation of Stage T1b Renal Cell Carcinoma: Safety, Technical Results, and Clinical Outcomes.

The use of percutaneous cryoablation for T1b (4.1-7.0 cm) renal cell carcinoma, has not yet been widely adopted. The purpose of this study was to describe our experience in the cryoablation of stage T1b tumors with an emphasis on safety, technical results, and clinical outcomes.

A retrospective review of hospital records identified 37 patients who underwent cryoablation for T1b lesions from 2008 to 2018. Patient demographics, comorbidities, tumor characteristics, technical parameters, and outcomes were recorded and analyzed. Recurrence-free, overall, and cancer-specific survival rates were estimated using the Kaplan-Meier method.

Thirty-seven patients (22 males, 15 females; mean age 66.5 ± 11.3) with 37 T1b tumors (mean diameter 47.3 ± 6.3 mm) were included. A median of 3 probes were used (range: 1-7). Angio-embolization was used in 3/37 (8.1%) and 2/37 patients (5.4%) required hydrodissection. The mean number of total cryoablation procedures for each patient was 1.5 (median 1; range: 1-4). Technical success was achieved in 88.2% of patients. Recurrence-free survival was 96.5%, 86.1%, and 62.6% at 1, 2, and 3 years respectively. Cancer-specific survival was 100% at 1, 2, and 3 years respectively. Overall survival was 96.7%, 91.8%, and 77.6% at 1, 2, and 3 years respectively. Complications classified as CIRSE grade 2 or higher occurred in 6/37 (16.2%) patients.

T1b cryoablation is associated with high rates of technical success, excellent cancer-specific survival, and an acceptable safety profile.

Level 4, Case Series.

Cardiovascular and interventional radiology. 2019 May 01 [Epub ahead of print]

Andrew J Gunn, Winston B Joe, Aliaksei Salei, Husameddin El Khudari, Khalid H Mahmoud, Eric Bready, Eric M Keasler, Patrick P Patten, Jennifer B Gordetsky, Soroush Rais-Bahrami, Ahmed K Abdel Aal

Division of Vascular and Interventional Radiology, Department of Radiology, University of Alabama at Birmingham, 619 19th St S, Birmingham, AL, 35249, UK. ., University of Alabama at Birmingham School of Medicine, 1720 2nd Ave. S., Birmingham, AL, 35294, UK., Division of Vascular and Interventional Radiology, Department of Radiology, University of Alabama at Birmingham, 619 19th St S, Birmingham, AL, 35249, UK., Department of Pathology, University of Alabama at Birmingham, 619 19th St S, Birmingham, AL, 35249, UK., Department of Urology, University of Alabama at Birmingham, 1720 2nd Ave. S., Birmingham, AL, 35294, UK.

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