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J Vasc Interv Radiol. 2008 Sep;19(9):1302-10. doi: 10.1016/j.jvir.2008.05.015. Epub 2008 Jul 11.

Safety and efficacy of CT-guided percutaneous cryoablation for renal cell carcinoma.

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1
Department of Vascular Interventional Radiology, Johns Hopkins Hospital, 600 North Wolfe Street, Blalock 544, Baltimore, MD 21287, USA. g_christos@hotmail.com

Abstract

PURPOSE:

Image-guided percutaneous cryoablation is a treatment alternative for selected patients with renal cell carcinoma (RCC). The objective of the present study was to present the safety and efficacy of percutaneous cryoablation.

MATERIALS AND METHODS:

The study included 51 lesions in 46 consecutive patients treated with computed tomography (CT)-guided percutaneous cryoablation. Results were based on 40 RCCs with follow-up. Patients had baseline history and physical and laboratory examinations and renal CT or magnetic resonance (MR) imaging and were followed every 3 months. Biopsy of all lesions was performed before or at the time of the procedure. Efficacy was defined as a complete lack of enhancement on follow-up contrast agent-enhanced CT or MR imaging. Lesion size was also followed and correlated with lack of enhancement. Short- and long-term complications were tabulated.

RESULTS:

The technical success rate was 100%, with 20% of cases requiring some form of thermal protection of an adjacent organ. During follow-up (median, 28 weeks; range, 4-81 weeks), the efficacy rate was 100% for lesions smaller than 7 cm. The incidence of significant complications was 18% (8% CTAE), mostly (10%) intercostal or genitofemoral nerve injury. All patients with complications recovered fully, and there were no mortalities. There was no change in creatinine levels, and no patient developed renal failure as a result of cryoablation.

CONCLUSIONS:

CT-guided percutaneous cryoablation resulted in complete response for lesions as large as 4 cm. It may also be a viable alternative for nonsurgical candidates with lesions as large as 7 cm. It has a high efficacy rate, and its modest complications are not only comparable to those of other treatment modalities, but also appear to be reversible.

PMID:
18725093
DOI:
10.1016/j.jvir.2008.05.015
[Indexed for MEDLINE]
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