Prospective analysis of the safety and efficacy of percutaneous cryoablation for pT1NxMx biopsy-proven renal cell carcinoma

Ronald Rodriguez, Ziga Cizman, Kelvin Hong, Alexandra Koliatsos, Christos Georgiades

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Purpose: Our objective was to determine the efficacy and safety of image-guided, percutaneous cryoablation for American Joint Committee on Cancer pT1ANxMx and pT1BNxMx biopsy-proven renal cell carcinoma (RCC). Materials and Methods: Computed tomography (CT)-guided, percutaneous cryoablation was used to treat 117 renal lesions in 113 consecutive patients with pT1NxMx RCC. All 117 ablations were included in the safety analysis, and complications were categorized according to Common Terminology Criteria for Adverse Events version 3.0 (CTCAE v3.0). Eighty-one lesions were biopsy-proven RCC and were included in the efficacy analysis. Technical success was defined as the "ice-ball" covering the entire lesion plus a minimum 5-mm margin. Efficacy was defined as complete lack of enhancement and continuous decrease in size on subsequent follow-up imaging studies. Results: Technical success was 100%, with 15% of ablations requiring air or saline injection to prevent nontarget ablation. We recorded a 7% rate of clinically significant complications (CTCAE category ≥2) and 0% mortality. Renal function was not adversely affected. Seventy percent of patients were discharged to home on the same day. Efficacy was 98.7% for a median follow-up of 67 weeks (range 7-172). For the subgroup of patients that reached a median follow-up of 2 (n = 59) and 3 years (n = 13), efficacy was 98.3 and 92.3%, respectively. Cancer specific survival was 100%. Conclusions: CT-guided, percutaneous cryoablation has an excellent safety and efficacy profile for stage T1A and T1B RCC; however, longer follow-up is needed to compare it with other nephron-sparing surgical treatments. It is a great option for nonsurgical patients, those in whom renal function cannot be further sacrificed, and those at risk for metachronous lesions.

Original languageEnglish (US)
Pages (from-to)573-578
Number of pages6
JournalCardioVascular and Interventional Radiology
Volume34
Issue number3
DOIs
StatePublished - Jun 2011
Externally publishedYes

Fingerprint

Cryosurgery
Renal Cell Carcinoma
Biopsy
Safety
Kidney
Tomography
Nephrons
Ice
Terminology
Neoplasms
Air
Injections
Survival
Mortality
Therapeutics

Keywords

  • Cryoablation
  • Percutaneous
  • Renal cell carcinoma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Prospective analysis of the safety and efficacy of percutaneous cryoablation for pT1NxMx biopsy-proven renal cell carcinoma. / Rodriguez, Ronald; Cizman, Ziga; Hong, Kelvin; Koliatsos, Alexandra; Georgiades, Christos.

In: CardioVascular and Interventional Radiology, Vol. 34, No. 3, 06.2011, p. 573-578.

Research output: Contribution to journalArticle

Rodriguez, Ronald ; Cizman, Ziga ; Hong, Kelvin ; Koliatsos, Alexandra ; Georgiades, Christos. / Prospective analysis of the safety and efficacy of percutaneous cryoablation for pT1NxMx biopsy-proven renal cell carcinoma. In: CardioVascular and Interventional Radiology. 2011 ; Vol. 34, No. 3. pp. 573-578.
@article{3db4d554b5fe4679a04ae051113af998,
title = "Prospective analysis of the safety and efficacy of percutaneous cryoablation for pT1NxMx biopsy-proven renal cell carcinoma",
abstract = "Purpose: Our objective was to determine the efficacy and safety of image-guided, percutaneous cryoablation for American Joint Committee on Cancer pT1ANxMx and pT1BNxMx biopsy-proven renal cell carcinoma (RCC). Materials and Methods: Computed tomography (CT)-guided, percutaneous cryoablation was used to treat 117 renal lesions in 113 consecutive patients with pT1NxMx RCC. All 117 ablations were included in the safety analysis, and complications were categorized according to Common Terminology Criteria for Adverse Events version 3.0 (CTCAE v3.0). Eighty-one lesions were biopsy-proven RCC and were included in the efficacy analysis. Technical success was defined as the {"}ice-ball{"} covering the entire lesion plus a minimum 5-mm margin. Efficacy was defined as complete lack of enhancement and continuous decrease in size on subsequent follow-up imaging studies. Results: Technical success was 100{\%}, with 15{\%} of ablations requiring air or saline injection to prevent nontarget ablation. We recorded a 7{\%} rate of clinically significant complications (CTCAE category ≥2) and 0{\%} mortality. Renal function was not adversely affected. Seventy percent of patients were discharged to home on the same day. Efficacy was 98.7{\%} for a median follow-up of 67 weeks (range 7-172). For the subgroup of patients that reached a median follow-up of 2 (n = 59) and 3 years (n = 13), efficacy was 98.3 and 92.3{\%}, respectively. Cancer specific survival was 100{\%}. Conclusions: CT-guided, percutaneous cryoablation has an excellent safety and efficacy profile for stage T1A and T1B RCC; however, longer follow-up is needed to compare it with other nephron-sparing surgical treatments. It is a great option for nonsurgical patients, those in whom renal function cannot be further sacrificed, and those at risk for metachronous lesions.",
keywords = "Cryoablation, Percutaneous, Renal cell carcinoma",
author = "Ronald Rodriguez and Ziga Cizman and Kelvin Hong and Alexandra Koliatsos and Christos Georgiades",
year = "2011",
month = "6",
doi = "10.1007/s00270-010-9934-7",
language = "English (US)",
volume = "34",
pages = "573--578",
journal = "CardioVascular and Interventional Radiology",
issn = "0174-1551",
publisher = "Springer Verlag",
number = "3",

}

TY - JOUR

T1 - Prospective analysis of the safety and efficacy of percutaneous cryoablation for pT1NxMx biopsy-proven renal cell carcinoma

AU - Rodriguez, Ronald

AU - Cizman, Ziga

AU - Hong, Kelvin

AU - Koliatsos, Alexandra

AU - Georgiades, Christos

PY - 2011/6

Y1 - 2011/6

N2 - Purpose: Our objective was to determine the efficacy and safety of image-guided, percutaneous cryoablation for American Joint Committee on Cancer pT1ANxMx and pT1BNxMx biopsy-proven renal cell carcinoma (RCC). Materials and Methods: Computed tomography (CT)-guided, percutaneous cryoablation was used to treat 117 renal lesions in 113 consecutive patients with pT1NxMx RCC. All 117 ablations were included in the safety analysis, and complications were categorized according to Common Terminology Criteria for Adverse Events version 3.0 (CTCAE v3.0). Eighty-one lesions were biopsy-proven RCC and were included in the efficacy analysis. Technical success was defined as the "ice-ball" covering the entire lesion plus a minimum 5-mm margin. Efficacy was defined as complete lack of enhancement and continuous decrease in size on subsequent follow-up imaging studies. Results: Technical success was 100%, with 15% of ablations requiring air or saline injection to prevent nontarget ablation. We recorded a 7% rate of clinically significant complications (CTCAE category ≥2) and 0% mortality. Renal function was not adversely affected. Seventy percent of patients were discharged to home on the same day. Efficacy was 98.7% for a median follow-up of 67 weeks (range 7-172). For the subgroup of patients that reached a median follow-up of 2 (n = 59) and 3 years (n = 13), efficacy was 98.3 and 92.3%, respectively. Cancer specific survival was 100%. Conclusions: CT-guided, percutaneous cryoablation has an excellent safety and efficacy profile for stage T1A and T1B RCC; however, longer follow-up is needed to compare it with other nephron-sparing surgical treatments. It is a great option for nonsurgical patients, those in whom renal function cannot be further sacrificed, and those at risk for metachronous lesions.

AB - Purpose: Our objective was to determine the efficacy and safety of image-guided, percutaneous cryoablation for American Joint Committee on Cancer pT1ANxMx and pT1BNxMx biopsy-proven renal cell carcinoma (RCC). Materials and Methods: Computed tomography (CT)-guided, percutaneous cryoablation was used to treat 117 renal lesions in 113 consecutive patients with pT1NxMx RCC. All 117 ablations were included in the safety analysis, and complications were categorized according to Common Terminology Criteria for Adverse Events version 3.0 (CTCAE v3.0). Eighty-one lesions were biopsy-proven RCC and were included in the efficacy analysis. Technical success was defined as the "ice-ball" covering the entire lesion plus a minimum 5-mm margin. Efficacy was defined as complete lack of enhancement and continuous decrease in size on subsequent follow-up imaging studies. Results: Technical success was 100%, with 15% of ablations requiring air or saline injection to prevent nontarget ablation. We recorded a 7% rate of clinically significant complications (CTCAE category ≥2) and 0% mortality. Renal function was not adversely affected. Seventy percent of patients were discharged to home on the same day. Efficacy was 98.7% for a median follow-up of 67 weeks (range 7-172). For the subgroup of patients that reached a median follow-up of 2 (n = 59) and 3 years (n = 13), efficacy was 98.3 and 92.3%, respectively. Cancer specific survival was 100%. Conclusions: CT-guided, percutaneous cryoablation has an excellent safety and efficacy profile for stage T1A and T1B RCC; however, longer follow-up is needed to compare it with other nephron-sparing surgical treatments. It is a great option for nonsurgical patients, those in whom renal function cannot be further sacrificed, and those at risk for metachronous lesions.

KW - Cryoablation

KW - Percutaneous

KW - Renal cell carcinoma

UR - http://www.scopus.com/inward/record.url?scp=79959596872&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79959596872&partnerID=8YFLogxK

U2 - 10.1007/s00270-010-9934-7

DO - 10.1007/s00270-010-9934-7

M3 - Article

C2 - 20628879

AN - SCOPUS:79959596872

VL - 34

SP - 573

EP - 578

JO - CardioVascular and Interventional Radiology

JF - CardioVascular and Interventional Radiology

SN - 0174-1551

IS - 3

ER -