To assess the safety, technical success, and clinical outcomes of percutaneous cryoablation (PCA) in patients with anterior renal tumors.
A retrospective analysis of patients with anterior renal tumors, defined as tumors at or anterior to the level of the renal pelvis, treated with CT-guided PCA from 2008 to 2022. Summary statistics included demographics and baseline tumor attributes. Treatment and follow-up metrics included primary and secondary technical success, adverse events (AEs) according to the SIR classification, local recurrence, overall survival (OS), and cancer-specific survival (CSS)). 100 patients (60 males; mean age: 63, mean BMI: 33, mean Charlson comorbidity index:6) with 100 anterior renal tumors were included.
78% of tumors were T1a and 22% T1b with mean maximal tumoral dimension of 29 mm (range: 6-62 mm) and mean distance to nearest critical structure 9 mm (range: 0-40 mm). Mean follow-up was 20.9 months (range: 3-103). 28% of PCAs required hydrodissection. Technical success was achieved in 92% of patients; with six remaining patients undergoing successful repeat PCA (secondary technical success: 98%). The remaining two patients without primary technical success were either surveilled or had a benign pathology on resulted concomitant biopsy. Four patients (4%) had major AEs (hemorrhage requiring prolonged admission, transfusion, or embolization (n = 3), perinephric abscess requiring drainage (n = 1)) and 27% had minor AEs. Eight patients (8%) had recurrence with a one-year OS of 94% and CSS of 100%. All recurrences underwent repeat ablation without additional recurrence and 3/8 (38%) were T1b and 5/8 (63%) were T1a tumors.
PCA of anterior renal tumors can be performed safely with high rates of technical and oncologic success.
Abdominal radiology (New York). 2023 Dec 27 [Epub ahead of print]
Junaid Raja, Richard Pigg, Yufeng Li, Cody Savage, Theresa M Caridi, Junjian Huang, Andrew J Gunn
Division of Vascular and Interventional Radiology, Department of Radiology, University of Alabama at Birmingham, 619 19th St SNHB 623, Birmingham, AL, 35249, USA., Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA., Division of Vascular and Interventional Radiology, Department of Radiology, University of Alabama at Birmingham, 619 19th St SNHB 623, Birmingham, AL, 35249, USA. .