3:18 PM Abstract No. 334 CT-guided adrenal mass cryoablation: a safe, well-visualized, and effective treatment

Abstract

To assess the technical feasibility, efficacy and complication rates of CT-guided percutaneous cryoablation of adrenal masses. 37 CT fluoroscopic-guided percutaneous cryoablations were performed on 37 metastatic tumors, in 31 patients, noting tumor size and type, vessel (>3 mm) proximity, recurrences, complications, and anesthesia-managed hypertension monitoring by arterial catheter. Of the 37 tumors, tumor origin was non–small cell lung (15), renal (15), sarcoma–ASPS (2), small cell lung (3), ovarian cancer (1) and colorectal (1). Complications followed the grading system of the National Institutes of Health, Common Terminology of Complications and Adverse Events (CTCAE). Local tumor recurrence and involution was monitored over time with 1, 3, 6, 12 month and annual scans thereafter. All patients required only conscious sedation. Average tumor and ablation size was 3.3 cm and 5.3 cm respectively. Local recurrence rate was 8.1% (3/37) for an average followup time of 1.3 years. Although recurrences for tumors > 3 cm (15.8% N = 3/19) were greater than for tumors <3 cm (0% N = 0/18), this was not statistically significant (p>0.05). Proximity of major vasculature (ie: aorta/IVC) did not affect recurrence rates (p>0.1). The major complication (> grade 3) rate was 8.1% (3/37), with two major complications attributable to the procedure. One death was due to a pulmonary embolism unrelated to the ablation procedure. Transient severe hypertension (>260/120) was noted in 2 cases which was rapidly managed medication without sequale. No significant intra or postprocedural changes in blood pressure since pretreatment with doxazocin was implemented (N = 8). CT-guided percutaneous cryoablation is a safe, effective and low morbidity alternative for patients with adrenal tumors. Transient hypertension is related only to residual viable adrenal tissue but can be safely managed.