Image-guided percutaneous renal cryoablation for stage 1 renal cell carcinoma with high surgical risk.

Xiang Yan,Wang Wei,Guo-Ping Shi,Yang Yang,Yang Wang,Rong Yang,Mingxin Zhang,Xiaoxiang Chen,Weidong Gan,Hongqian Guo

doi:10.1186/s12957-015-0610-x

Abstract

BackgroundThis study was undertaken to evaluate the feasibility, safety, and therapeutic effects of percutaneous renal cryoablation under local anesthesia with conscious sedation for patients who have unresectable stage 1 (T1NoMo) renal cell carcinoma (RCC) in high surgical risk.MethodsEighteen patients who were not candidates for surgery underwent primary cryosurgery guided by gray-scale ultrasound. Contrast-enhanced ultrasonography (CEUS) and contrast-enhanced computed tomography (CT) were performed to evaluate treatment at completion.ResultsThe mean follow-up period was 26.8 months (range, 12–56 months). All tumors were biopsied before cryosurgery. Seventeen tumors remained free of enhancement during follow-up period. No major complications associated with cryoablation procedures were found though two instances of subcapsular hematomas, one of retroperitoneal errhysis and one of nausea, were seen after cryoablation. One patient had a local recurrence of tumor and received additional cryoablation. Local tumor control rate was 100 % of T1NoMo tumors including the recurrence case who underwent additional cryoablation.ConclusionsPercutaneous cryoablation can be recommended as a feasible, safe, and promising therapy for the treatment of renal tumor, especially those unresectable stage 1 RCC, with a low risk of complications.

Highlights

This study was undertaken to evaluate the feasibility, safety, and therapeutic effects of percutaneous renal cryoablation under local anesthesia with conscious sedation for patients who have unresectable stage 1 (T1NoMo) renal cell carcinoma (RCC) in high surgical risk
Despite that less invasive surgical procedures such as laparoscopic partial nephrectomy [3] and laparoscopic renal cryoablation [4] have been performed in select patients, the demand for further reductions in therapy and general anesthesia related to morbidity is desirable
We evaluated the feasibility, safety, and therapeutic effects of percutaneous renal cryoablation for patients with high surgical risk after a 2-year mean follow-up

Summary

Introduction

This study was undertaken to evaluate the feasibility, safety, and therapeutic effects of percutaneous renal cryoablation under local anesthesia with conscious sedation for patients who have unresectable stage 1 (T1NoMo) renal cell carcinoma (RCC) in high surgical risk. Despite that less invasive surgical procedures such as laparoscopic partial nephrectomy [3] and laparoscopic renal cryoablation [4] have been performed in select patients, the demand for further reductions in therapy and general anesthesia related to morbidity is desirable. In high-risk patients, an even less invasive treatment such as percutaneous renal cryoablation would be feasible. For some high-surgical-risk patients, we were able to perform percutaneous cryoablation under local anesthesia with conscious sedation

Methods

Results

Discussion

Conclusion