Safety and efficacy of CT-guided percutaneous cryoablation for renal cell carcinoma
Georgiades CS et al. - In a study to assess the safety and efficacy of percutaneous cryoablation for renal cell carcinoma (RCC), 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 Methods- The study included 51 lesions in 46 consecutive pts treated with computed tomography (CT)–guided percutaneous cryoablation
- Results were based on 40 RCCs with follow-up
- Pts 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 followed and correlated with lack of enhancement
- Short- and long-term complications were tabulated
Results- Technical success rate was 100%, with 20% of cases requiring some form of thermal protection of an adjacent organ
- During follow-up, the efficacy rate was 100% for lesions smaller than 7 cm
- Incidence of significant complications was 18%, mostly (10%) intercostal or genitofemoral nerve injury
- All pts with complications recovered fully, and there were no mortalities
- There was no change in creatinine levels, and no pt developed renal failure as a result of cryoablation
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