Faculty Collaboration Database

Percutaneous Cryoablation of Solitary, Sporadic Renal Cell Carcinoma: Outcome Analysis Based on Clear-Cell versus Papillary Subtypes. J Vasc Interv Radiol 2018 Aug;29(8):1122-1126

Date

06/12/2018

Pubmed ID

29887184

DOI

10.1016/j.jvir.2018.02.029

Scopus ID

2-s2.0-85048212054 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

PURPOSE: To evaluate treatment outcomes with percutaneous cryoablation (PCA) based on renal cell carcinoma (RCC) histology.

METHODS AND MATERIALS: Patients treated with PCA for a solitary, sporadic stage T1a RCC from 2003 to 2016 were identified from a single institution's renal ablation registry. Patients with multiple tumors, history of RCC, or genetic syndromes associated with RCC (n = 60); no specific RCC subtype determined from core biopsy (n = 66); RCC subtype other than clear-cell or papillary (n = 7); or less than 3 mo of follow-up imaging (n = 5) were excluded. In total, 173 patients met study inclusion criteria. Oncologic outcomes, clinical outcomes, and complications were evaluated based on tumor subtype.

RESULTS: Of the 173 patients who underwent PCA for a stage T1a RCC, 130 (75%) had clear-cell RCC (ccRCC) and 43 (25%) had papillary RCC (pRCC). Median tumor size was 2.9 cm (range, 1.3-4.0 cm). Technically successful cryoablation was achieved in all 173 patients. Local tumor recurrence developed in 6 patients with ccRCC (4.6%), new renal tumors developed in 1 patient (0.8%), and metastatic RCC developed in 1 patient (0.8%) who also had local tumor recurrence. No patients with pRCC showed local tumor recurrence, new renal tumors, or metastatic disease. The 5-year disease-free survival rate in patients with ccRCC was 88%, compared with 100% in patients with pRCC (P = .48). Nine patients (5.2%), all with ccRCC, experienced major complications (P = .11).

CONCLUSIONS: Percutaneous ablation is a viable treatment option for patients with clinical stage T1a pRCC and ccRCC. Percutaneous ablation may be a very favorable treatment strategy particularly for pRCC.

Author List

Haddad MM, Schmit GD, Kurup AN, Schmitz JJ, Boorjian SA, Geske J, Thompson RH, Callstrom MR, Atwell TD

Author

Mustafa Haddad MD Assistant Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Biopsy, Large-Core Needle
Carcinoma, Renal Cell
Cryosurgery
Disease Progression
Disease-Free Survival
Female
Humans
Kidney Neoplasms
Male
Middle Aged
Minnesota
Neoplasm Recurrence, Local
Neoplasm Staging
Registries
Retrospective Studies
Time Factors
Treatment Outcome
Tumor Burden