• Medientyp: E-Artikel
  • Titel: Safety, efficacy, and mid-term oncological outcomes of computed tomography-guided cryoablation of T1 renal cancer
  • Beteiligte: Duus, Louise A; Junker, Theresa; Rasmussen, Benjamin S; Bojsen, Jonas A; Pedersen, Allan L; Anthonsen, Andrea; Lund, Lars; Pedersen, Michael; Graumann, Ole
  • Erschienen: SAGE Publications, 2023
  • Erschienen in: Acta Radiologica, 64 (2023) 2, Seite 814-820
  • Sprache: Englisch
  • DOI: 10.1177/02841851221081825
  • ISSN: 0284-1851; 1600-0455
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  • Beschreibung: Background Cryoablation is a promising minimally invasive, nephron-sparing treatment of small renal carcinoma (RCC) in co-morbid patients. Purpose To assess the safety, efficacy, and cancer-specific outcomes of computed tomography (CT)-guided cryoablation of stage T1 (RCC). Material and Methods A retrospective evaluation of 122 consecutive patients with 128 tumors treated with cryoablation during 2016–2017. All patients had biopsy-verified T1 RCC. Results Median age was 69 years (IQR=59–76); 69% were male. Median tumor size was 26 mm (± 20–33); 9% were stage T1b. Mean follow-up time was 36.3±12.0 months. In total, 14 (11%) procedures led to complications, of which 4 (3%) were intraoperative, 5 (4%) appeared ≤30 days and 5 (4%) >30 days after treatment. Major complications arose after 4 (3%) procedures. Statistically significant associations were found between major complications and stage T1b ( P = 0.039), RENAL score ( P = 0.010), and number of needles used in cryoablation ( P = 0.004). Residual tumor was detected after 4 (3%) procedures and 5 (4%) tumors had local tumor progression. Of 122 patients, 3 (2%) advanced to metastatic disease. Significant statistical associations were found between local tumor progression and T1b stage tumors and number of needles used in cryoablation ( P = 0.05 and P = 0.004, respectively). For patients with T1a tumors, the one- and three-year disease-free survival was 98% and 95%, respectively, and for T1b 100% after one year and 75% after three years. Conclusions This study showed that cryoablation is a safe and effective treatment of stage T1 RCC and suggests that in selecting candidates for cryoablation of RCC, the tumor characteristics are more critical than patients’ baseline health status.