Impact of Percutaneous Cryoablation on Renal Function in Patients with Stage I Renal Cell Carcinoma: A Systematic Review and Meta-Analysis.

To assess the effect of cryoablation on renal function (measured by eGFR or serum creatinine) for treating Stage I renal cancer.

MEDLINE, EMBASE, and the CENTRAL databases were systematically searched from inception to May 1, 2023. Cohort studies that included data on change of estimated glomerular filtration rate (eGFR) and serum creatinine increase were included. Meta-analysis was performed by measuring the weighted mean difference and by fitting random-effect models.

Overall, 38 studies were included, comprising of 3,202 participants. Percutaneous cryoablation was associated with an absolute eGFFR reduction of -3.06 ml/min/1.73 m2 (95% CI: -4.12 to -2.01; p-value < 0.001) and serum creatinine increase of 0.05 mg/dl (95% CI: -0.02 to 0.11; p-value> 0.05). The weighted absolute mean difference of percutaneous cryoablation for treating stage T1b renal cell carcinoma was estimated at -5.19 ml/min/1.73 m2 (95% CI: -11.1 to 0.72; p-value > 0.05). Lastly, when analyzing studies that included cohorts with solitary kidneys, the pooled weighted mean difference was estimated as -3.27 ml/min/1.73 m2 (95% CI: -6.79 to 0.25; pvalue >0.05).

Percutaneous cryoablation for Stage 1 renal cell carcinoma has minimal significant impact on renal function (measured by eGFR or serum creatinine). The same outcome was observed in patients with larger tumors (T1b) and those with solitary kidneys.

Journal of vascular and interventional radiology : JVIR. 2024 Jun 22 [Epub ahead of print]

David-Dimitris Chlorogiannis, Anargyros Chlorogiannis, Dimitrios K Filippiadis, Alexis Kelekis, Gregory C Makris, Christos Georgiades

Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America. Electronic address: ., Department of Health Economics, Policy and Management, Karolinska Institutet, Stockholm, Sweden. Electronic address: ., 2nd Department of Radiology, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: ., 2nd Department of Radiology, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: ., Department of Vascular and Interventional Radiology, Guy's and St Thomas Hospital, NHS Foundation Trust, London, UK. Electronic address: ., Department of Vascular and Interventional Radiology, Johns Hopkins University, Baltimore, United States of America. Electronic address: .