Safety and Oncologic Outcomes of Percutaneous Cryoablation of Renal Cell Carcinoma Recurrences in the Ipsilateral Kidney Following Partial Nephrectomy

Cardiovasc Intervent Radiol. 2022 May;45(5):656-664. doi: 10.1007/s00270-022-03079-1. Epub 2022 Mar 10.

Abstract

Purpose: To retrospectively investigate the safety and oncological outcomes of cryoablation performed on residual/recurring renal cell carcinoma (RCC) in the ipsilateral kidney following partial nephrectomy (PN).

Materials and methods: Data dealing with patients', RCC, procedure (including the length of the hospital stay), and follow-up (technical efficacy [TE], local tumor progression-free survival [LTPFS], disease-free survival [DFS], metastasis-free survival [MFS], cancer-specific survival (CSS), and overall survival [OS]) were retrospectively collected and analyzed.

Results: Between January 2008 and November 2020, 21 consecutive patients (17 [81%] men; 4 [19%] women; median age 68 years; range 43-82) underwent cryoablation due to residual/recurring RCC in the PN site (15 patients) or de-novo RCC (6 patients) in the ipsilateral kidney. Median tumor size was 2.2 cm (mean 2.3 cm; range 0.8-4; interquartile range [IQR] 1.9-3). There were two (2/21; 10%) minor self-limiting hemorrhagic complications, both occurring in the group of patients with RCC in the PN site. Median hospital stay was 2 days (mean 2.1; range 1-5; IQR 2-2). TE was 100% (21/21 patients), and 10-year estimates of LTPFS, MFS and DFS were 74.1% (95% confidence intervals [CI] 56.8-96.7%), 36.4% (95% CI 14.2-93.8%), and 43.5% (95% CI 21.9-86.4%), respectively. CSS and OS were 100% at the last available follow-up (median 56 months; mean 67.4; range: 12-147; IQR:34-95).

Conclusion: Cryoablation in patients with residual/recurring RCC following PN is safe and results in high 10-year estimates of LTPFS.

Keywords: Cryotherapy; Kidney; Local neoplasm recurrences; Partial nephrectomy; Renal cell carcinoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Renal Cell* / diagnostic imaging
  • Carcinoma, Renal Cell* / surgery
  • Chronic Disease
  • Cryosurgery* / methods
  • Female
  • Humans
  • Kidney / pathology
  • Kidney Neoplasms* / diagnostic imaging
  • Kidney Neoplasms* / surgery
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / surgery
  • Nephrectomy / methods
  • Retrospective Studies
  • Treatment Outcome