Image-guided percutaneous cryoablation of T1b renal cell carcinomas in patients with comorbidities.

Abstract

To investigate the influence of comorbidities and tumor characteristics on outcomes following percutaneous cryoablation (PCA) of T1b renal cell carcinoma (RCC). Age-adjusted Charlson comorbidity index (ACCI); standardized system for quantitating renal tumor size, location, and depth (RENAL nephrometry score [RNS]); and local tumor control and survival were retrospectively investigated in 28 patients who underwent PCA for stage T1b RCC. Risk factors for elevated serum creatinine levels were also investigated. Complete ablation was obtained in 27 of 28 patients. Two cases of metastasis were observed; one patient died 12months after PCA. Overall survival at 5years was 79.1%, with a mean follow-up of 42.0 ± 16.0months. Local tumor control was not correlated with the ACCI and RNS. Worsening renal function 3months after PCA was observed in ten patients, and it correlated with the presence of single kidneys (7/28 patients; p = 0.023). Significant worsening of renal function continued until 1year after PCA (p = 0.013). Having a single kidney was a risk factor for worsened renal function after PCA (odds ratio, 8.00; 95% confidence interval 1.170-54.724). PCA for T1b RCC confers positive local tumor control regardless of comorbidities and tumor characteristics.