Lim, E;
Kumar, S;
Seager, M;
Modi, S;
Mandal, I;
Neves, J;
Jones, S;
... Walkden, M; + view all
(2020)
Outcomes of renal tumours treated by image-guided percutaneous cryoablation: immediate, 3- and 5- year outcomes at a regional center.
American Journal of Roentgenology
10.2214/AJR.19.22213.
(In press).
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Abstract
Objective: The purpose of this study was to evaluate the immediate, and 3- and 5-year outcomes of patients with clinical stage T1 (cT1) biopsy-proven renal cell carcinoma (RCC) treated by image-guided percutaneous cryoablation at a regional interventional oncology center. Materials and Methods: We interrogated a prospectively maintained local interventional radiology database and identified 180 patients in whom 185 separate cT1 RCC lesions were treated by percutaneous cryoablation. Technical success, procedural complications (graded using the Clavien-Dindo classification system), and the residual unablated tumor rate were collated. Local tumor progression-free survival was estimated using Kaplan-Meier methodology. Results: Mean patient age was 68.4 years (range 34.1-88.9) and 52 (28.9%) were female. There were 168 (90.8%) and 17 (9.2%) cT1a and cT1b lesions, respectively, with a mean lesion size of 28.5 mm (range 11-58 mm). Technical success was achieved in 183/185 (98.9%). The major complication rate (Clavien-Dindo≥III) was 4/185 (2.1%). Residual unablated tumor on the first follow-up scan was identified in 3/183 (1.6%). Estimated local tumor progressionfree survival at 3 and 5 years were 98.3% and 94.9%, respectively. No distant metastases or deaths attributable to RCC occurred. Mean eGFR pre procedure was 72.4 ml/min per 1.73m2 (SD±18.5) and this was not significantly different post-procedure (69.7, SD±18.8), at 1 year (70.7, SD±16.4) or 2 years (69.8, SD±18.9) (P>0.05). Conclusion: These data add to the accumulating evidence that image-guided cryoablation is an efficacious treatment for selected cT1 RCC with a low complication rate and robust 3- and 5- year outcomes.
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