REGULAR CONTENT
Final ID
462
Type
Original Scientific Research-Poster Only
Authors
M Haddad1, A Weisbrod1, G Schmit1, A Kurup1, M Callstrom1, C Lohse1, S Boorjian1, R Thompson1, T Atwell1
Institutions
1Mayo Clinic, Rochester, MN
Purpose
Evaluate whether percutaneous cryoablation is an efficacious and safe treatment for centrally located renal cell carcinoma (RCC).
Materials & Methods
Outcomes were analyzed following 172 percutaneous cryoablation procedures performed from 2003 to 2015 to treat centrally located (i.e. extending to the renal sinus fat) RCC's. Cryoablation procedures (n=24) that included concurrent treatment of non-central tumors or with radiofrequency ablation were excluded from complication analysis. Tumor characteristics, oncologic outcomes, and complications were evaluated.
Results
One hundred seventy-six central RCC's with a median size of 3.5 cm (1.0-9.7cm) were treated in 169 patients during 172 cryoablation procedures. 122 (69%) RCC's were cT1a clear cell RCC, 44(25%) were cT1b clear cell RCC, and 10(6%) were cT2a clear cell RCC. Technical failure was observed in 3 (1.7%) RCC's. One hundred sixty-one RCC's were followed for 3 months or longer, and of these, 8 (5.0%) recurred at a mean of 2.4 years following cryoablation. The median follow-up duration of the 151 RCC's that did not recur was 2.6 years (range 0.25-11.25). Estimated recurrence-free survival rates (95% CI; number still at risk) at 1, 3, and 5 years following cryoablation were 98.6% (97.6-100;138)), 94.8% (92.7-100;76), and 89.8% (85.7-100;29), respectively. Median hospital stay was 1 night. Clavien-Dindo grade 3 or greater complications occurred following 23 of the 148 (15.5%) evaluated procedures. The most frequent major complication was related to hemorrhage. Major complications were associated with tumor size and number of probes used.
Conclusions
Percutaneous cryoablation of RCC's extending centrally into the kidney is associated with a reasonable rate of local tumor control, although complications are more frequent than previously published. The relatively high major complication rate warrants a higher level of peri-procedural care, especially in larger tumors that require a greater number of probes.
Final ID
462
Type
Original Scientific Research-Poster Only
Authors
M Haddad1, A Weisbrod1, G Schmit1, A Kurup1, M Callstrom1, C Lohse1, S Boorjian1, R Thompson1, T Atwell1
Institutions
1Mayo Clinic, Rochester, MN
Purpose
Evaluate whether percutaneous cryoablation is an efficacious and safe treatment for centrally located renal cell carcinoma (RCC).
Materials & Methods
Outcomes were analyzed following 172 percutaneous cryoablation procedures performed from 2003 to 2015 to treat centrally located (i.e. extending to the renal sinus fat) RCC's. Cryoablation procedures (n=24) that included concurrent treatment of non-central tumors or with radiofrequency ablation were excluded from complication analysis. Tumor characteristics, oncologic outcomes, and complications were evaluated.
Results
One hundred seventy-six central RCC's with a median size of 3.5 cm (1.0-9.7cm) were treated in 169 patients during 172 cryoablation procedures. 122 (69%) RCC's were cT1a clear cell RCC, 44(25%) were cT1b clear cell RCC, and 10(6%) were cT2a clear cell RCC. Technical failure was observed in 3 (1.7%) RCC's. One hundred sixty-one RCC's were followed for 3 months or longer, and of these, 8 (5.0%) recurred at a mean of 2.4 years following cryoablation. The median follow-up duration of the 151 RCC's that did not recur was 2.6 years (range 0.25-11.25). Estimated recurrence-free survival rates (95% CI; number still at risk) at 1, 3, and 5 years following cryoablation were 98.6% (97.6-100;138)), 94.8% (92.7-100;76), and 89.8% (85.7-100;29), respectively. Median hospital stay was 1 night. Clavien-Dindo grade 3 or greater complications occurred following 23 of the 148 (15.5%) evaluated procedures. The most frequent major complication was related to hemorrhage. Major complications were associated with tumor size and number of probes used.
Conclusions
Percutaneous cryoablation of RCC's extending centrally into the kidney is associated with a reasonable rate of local tumor control, although complications are more frequent than previously published. The relatively high major complication rate warrants a higher level of peri-procedural care, especially in larger tumors that require a greater number of probes.