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DOI: 10.4103/AJIR.AJIR_29_17
Safety and Efficacy of Cryoablation of Renal Tumors in a High-Risk Patient Population at a Community Hospital
Financial support and sponsorship Nil.
Purpose: The purpose of the study was to evaluate the safety and efficacy of percutaneous cryoablation for the treatment of renal masses in a high surgical risk population stratified by Charlson Comorbidity Index treated at a community hospital and to determine parameters associated with higher complication rates. Materials and Methods: A retrospective chart review of patients with renal masses treated with image-guided percutaneous cryoablation between 2007 and 2013 was performed. Results: A total of 121 tumors were ablated in 105 patients. The mean patient age was 70 years old. Comorbidities included morbid obesity, hypertension, diabetes mellitus, coronary artery disease, pulmonary disease, cigarette use, and renal insufficiency. Mean tumor size treated was 3.15 cm in largest diameter, ranging from 1.4 to 6.5 cm. Complications were observed in 16 cases. The most common complication was perinephric and/or pararenal hemorrhage. Procedures with >3.5 probes, hemoglobin >12.5 g/dl, tumor size >3.55 cm, and age >75 years were all associated with greater likelihood of complications. Conclusions: Our experience with percutaneous cryoablation of small renal masses offers similar results in efficacy to published data in patients with significant comorbidities. In addition, the results of our study show that percutaneous cryoablation is relatively safe in patients with renal cancer who are poor surgical candidates but warrants special consideration. Parameters associated with higher rates of complications have been established, which may be used by physicians as a guide.
Publication History
Article published online:
26 March 2021
© 2018. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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References
- 1 Homma Y, Kawabe K, Kitamura T, Nishimura Y, Shinohara M, Kondo Y, et al. Increased incidental detection and reduced mortality in renal cancer – Recent retrospective analysis at eight institutions. Int J Urol 1995;2:77-80.
- 2 Fergany AF, Hafez KS, Novick AC. Long-term results of nephron sparing surgery for localized renal cell carcinoma: 10-year followup. J Urol 2000;163:442-5.
- 3 Woldu SL, Thoreson GR, Okhunov Z, Ghandour R, Rothberg MB, RoyChoudhury A, et al. Comparison of renal parenchymal volume preservation between partial nephrectomy, cryoablation, and radiofrequency ablation using 3D volume measurements. J Endourol 2015;29:948-55.
- 4 Patel U, Sokhi H. Imaging in the follow-up of renal cell carcinoma. AJR Am J Roentgenol 2012;198:1266-76.
- 5 Common Terminology Criteria for Adverse Events (CTCAE). U.S. Department of Health and Human Services. National Institutes of Health. National Cancer Institute; 28 May, 2009. Available from: https://www.evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010-06-14_QuickReference_5x7.pdf. [Last accessed on 2017 Dec 17; Last updated on 2010 Jun 14].
- 6 Ahmed M, Solbiati L, Brace CL, Breen DJ, Callstrom MR, Charboneau JW, et al. Image-guided tumor ablation: Standardization of terminology and reporting criteria – A 10-year update. J Vasc Interv Radiol 2014;25:1691-705.
- 7 Simon TG, Beland MD, Machan JT, Dipetrillo T, Dupuy DE. Charlson comorbidity index predicts patient outcome, in cases of inoperable non-small cell lung cancer treated with radiofrequency ablation. Eur J Radiol 2012;81:4167-72.
- 8 Babaian KN, Okhunov Z, Juncal S, Ordon M, Lusch A, Zand T, et al. Clinical outcomes of patients with nondiagnostic biopsy during cryoablation of small renal masses. Urology 2015;85:605-9.
- 9 Kim EH, Tanagho YS, Bhayani SB, Saad NE, Benway BM, Figenshau RS, et al. Percutaneous cryoablation of renal masses: Washington university experience of treating 129 tumours. BJU Int 2013;111:872-9.
- 10 Atwell TD, Carter RE, Schmit GD, Carr CM, Boorjian SA, Curry TB, et al. Complications following 573 percutaneous renal radiofrequency and cryoablation procedures. J Vasc Interv Radiol 2012;23:48-54.
- 11 Maria T, Georgiades C. Percutaneous cryoablation for renal cell carcinoma. J Kidney Cancer VHL 2015;2:105-13.
- 12 Kunkle DA, Uzzo RG. Cryoablation or radiofrequency ablation of the small renal mass: A meta-analysis. Cancer 2008;113:2671-80.
- 13 Kurup AN. Percutaneous ablation for small renal masses-complications. Semin Intervent Radiol 2014;31:42-9.
- 14 Miller JM, Julien P, Wachsman A, Van Allan RJ, Friedman ML. The role of embolization in reducing the complications of cryoablation in renal cell carcinoma. Clin Radiol 2014;69:1045-9.