Computed tomography imaging-guided percutaneous argon-helium cryoablation of muscle-invasive bladder cancer: initial experience in 32 patients

Cryobiology. 2014 Oct;69(2):318-22. doi: 10.1016/j.cryobiol.2014.08.006. Epub 2014 Aug 26.

Abstract

Purpose: To evaluate the initial clinical experience of computed tomography (CT) imaging-guided percutaneous cryotherapy of bladder cancer.

Patients and methods: This study was approved by the human subjects committee. Written informed consent was obtained from all patients. Thirty-two patients (22 males and 10 females; mean age, 62.7 years) with muscle-invasive bladder cancer were treated with CT imaging-guided percutaneous cryoablation. By using CT imaging system and local anesthesia in patients, a single or multiple 1.47 mm cryoprobes were used to freeze the target bladder tumor (mean tumor size, 2.8 cm; range, 1.3-4.5 cm) with a dual freeze-thaw cycle. Follow-up was performed to assess the clinical and technical outcome of patients treated with cryoablation for a minimum of 6 months (mean, 33 months; range, 6-48 months). Tumors were considered completely ablated if there was no evidence to suggest tumor enhancement at follow-up CT images.

Results: Bladder cryoablation was clinically and technically successful in all 32 cases, 30 of which required only one treatment session. Bladder integrity was maintained in all patients. Major complications were not observed in any patient.

Conclusion: Our initial experience of a minimally invasive method for ablating bladder tumors with CT imaging-guided percutaneous argon-helium cryoablation appears to be favorable, with acceptable operative and short-term clinical outcomes. The technique is safe and effective for the treatment of patients with muscle-invasive bladder cancer; however, long-term follow-up is needed.

Keywords: Argon–helium cryoablation; Bladder cancer; Computed tomography.

MeSH terms

  • Aged
  • Argon / therapeutic use*
  • Cryosurgery / instrumentation
  • Cryosurgery / methods*
  • Equipment Design
  • Female
  • Helium / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Muscle Neoplasms / secondary*
  • Tomography, X-Ray Computed / instrumentation
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Urinary Bladder / pathology
  • Urinary Bladder / surgery*
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / surgery*

Substances

  • Helium
  • Argon