Predictors of Outcomes of Percutaneous Cryoablation for Renal Cell Carcinoma

Objectives: To evaluate the clinical and technical factors affecting the outcomes of percutaneous cryoablation (PCA) of renal cell carcinoma (RCC). Methods: The medical records of the patients who underwent PCA for RCC between 2004 and 2018 were retrospectively reviewed, and 128 patients were included. Patient demographics, tumor characteristics, technical success defined as absence of residual tumor within 3 months of procedure, and complications were reported. Recurrence-free, cancer-specific, and overall survival rates were analyzed. A univariate analysis was performed to identify any potential predictors of the outcomes. Results: Mean age of the patients was 65 (standard deviation = 11.5) years. Chronic kidney disease at the baseline was seen in 38.3% of patients. The median tumor size was 3.0 (range: 1.2–8.7) cm with 73 (57%) posterior tumor location. The study included T1a (69.5%) and T1b (28.9%) tumors. The median number of probes used was 2 (range: 1–7), and 81 (63.3%) tumors were biopsied. Technical success rate was 90.6%. Minor complications were seen in 26.6% and major in 6.3% of the patients. On univariate analysis, tumor biopsy (P = 0.019), endophytic/mixed location (P = 0.026), nearness to collecting system (P = 0.012), and renal sinus involvement (P = 0.003) were associated with complications, and the latter two were associated with decreased overall survival (P = 0.036 and P = 0.051, respectively). None of the variables predict local recurrence. The recurrence-free, cancer-specific, and overall survival at 3 years was 66.6%, 100%, and 93.4%, respectively. Conclusion: Tumor biopsy, tumor location, nearness to collecting system, and renal sinus involvement were the predictors of outcomes of PCA of RCC.

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Artikel online veröffentlicht:
26. April 2021