Cryoablation of renal cell carcinoma for patients with stage 4 or 5 non-dialysis chronic kidney disease

Jpn J Radiol. 2019 Jun;37(6):481-486. doi: 10.1007/s11604-019-00821-7. Epub 2019 Apr 2.

Abstract

Purpose: To evaluate the safety and efficacy of cryoablation for renal cell carcinoma (RCC) in patients with stage 4 or 5 non-dialysis chronic kidney disease (CKD).

Materials and methods: This retrospective multicenter study included patients with maximum tumor diameter ≤ 4 cm, estimated glomerular filtration rate (eGFR) < 30 ml/min/1.73 m2, in whom cryoablation was performed percutaneously with curative intent between July 2011 and May 2016.

Results: Of 541 patients who underwent renal tumor cryoablation, 17 (3.1%; 4 women, 13 men; mean age 70.1 ± 10.6 years) with stage 4 or 5 non-dialysis CKD were included in this study. The pre-cryoablation eGFR was 22.5 ± 6.3 ml/min/1.73 m2. The mean tumor diameter was 2.8 ± 0.7 cm. No Grade 3 or higher adverse events occurred post-cryoablation. The eGFR at each time point was significantly lower than that before treatment. One patient required hemodialysis initiation at 21 months post-procedure. None of the patients showed residual RCC at their last follow-up.

Conclusion: Cryoablation of RCC is safe in patients with stage 4 or 5 non-dialysis CKD and yields treatment results comparable to those in patients without CKD. This treatment could be completed without the early initiation of hemodialysis after the procedure.

Keywords: Chronic kidney disease; Cryoablation; Kidney; Renal cell carcinoma; Stage 4.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Renal Cell / complications
  • Carcinoma, Renal Cell / pathology
  • Carcinoma, Renal Cell / surgery*
  • Cryosurgery / methods*
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Kidney / pathology
  • Kidney / surgery
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / pathology
  • Kidney Neoplasms / complications
  • Kidney Neoplasms / pathology
  • Kidney Neoplasms / surgery*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome