Diagnostic and Interventional Radiology
Interventional Radiology - Original Article

Long-term outcomes of CT-guided percutaneous cryoablation of T1a and T1b renal cell carcinoma

1.

Department of Clinical Radiology, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK

2.

Division of Interventional Radiology, 2nd Department of Radiology, National and Kapodistrian University of Athens School of Medicine, Attikon University General Hospital, Athens, Greece

Diagn Interv Radiol 2021; 27: 524-528
DOI: 10.5152/dir.2021.20342
Read: 203 Downloads: 32 Published: 17 July 2020

PURPOSE 
We aimed to evaluate the long-term outcomes of computed tomography-guided percutaneous cryoablation (PCA) for biopsy-confirmed renal cell carcinoma (RCC).

METHODS
This was a single-center, retrospective study investigating all patients treated with PCA between January 2010 and February 2019 for RCC tumors. Primary outcome measures included overall survival (OS), disease-free survival (DFS), progression-free survival (PFS) and cancer-specific survival (CSS). Secondary outcome measures included kidney function, complications, technical success, hospital stay, procedural time, and the identification of factors affecting the primary outcomes. 

RESULTS
Fifty-three consecutive patients with 54 lesions (T1a: 49/54; T1b: 5/54) were included. Mean tumor diameter was 28.0±8.5 mm and mean R.E.N.A.L. score was 7.2±2.0. Technical success was 100% (54/54 lesions) after two reinterventions for incomplete ablation. Mean follow-up time was 46.7±28.6 months (range, 3–122 months). Local recurrence was noted in 5 patients (9.2%). According to Kaplan-Meyer analysis, OS was 98.2%, 94.2%, 71.2%, and 58.2% at 1, 3, 5, and 8 years. One patient (1.9%) died of cancer and CSS was 95.8% at 8 years. DFS was 100.0%, 95.5%, and 88.6%, and PFS was 100%, 94.3%, and 91.0%, at 1, 2, and 5 years. Clavien–Dindo grade II complication rate was 7.8% (5/64 procedures). There were no complications classified as grade III or greater. Mean creatinine increase was 7.1±6.3 μm/L (p = 0.31). No patient advanced to dialysis during follow up. Mean procedural time was 163±45 min. Median hospital stay was 2.0 days (IQR, 1–2.5 days). Diabetes was the only independent predictor of decreased OS (hazard ratio 4.3, 95% CI 0.043–0.914; p = 0.038).

CONCLUSION
PCA for stage T1a and T1b RCC provides favorable long-term oncological and renal function preservation outcomes, with acceptable complication rates.

You may cite this article as: Spiliopoulos S, Marzoug A, Ra H, Ragupathy SKA. Long-term outcomes of CT-guided percutaneous cryoablation of T1a and T1b renal cell carcinoma. Diagn Interv Radiol 2021; 27:524-528

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