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Outcomes of renal tumours treated by image-guided percutaneous cryoablation: immediate, 3- and 5- year outcomes at a regional center

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.

Type: Article
Title: Outcomes of renal tumours treated by image-guided percutaneous cryoablation: immediate, 3- and 5- year outcomes at a regional center
DOI: 10.2214/AJR.19.22213
Publisher version: http://dx.doi.org/10.2214/AJR.19.22213
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: cryotherapy, interventional radiology, percutaneous cryoablation, renal cell carcinoma
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology
URI: https://discovery.ucl.ac.uk/id/eprint/10087713
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