• Thomas D Atwell, Jay J Vlaminck, Stephen A Boorjian, Anil N Kurup, Matthew R Callstrom, Adam J Weisbrod, Christine M Lohse, William R Hartman, Andrew H Stockland, Bradley C Leibovich, Grant D Schmit, and Robert H Thompson.
• Departments of Radiology, Mayo Clinic, Mayo Building, E2, 200 First St. SW, Rochester, MN 55905.. Electronic address: atwell.thomas@mayo.edu.
• J Vasc Interv Radiol. 2015 Jun 1; 26 (6): 792-9.

PurposeTo describe the technical methods, safety, and local tumor control rate associated with percutaneous cryoablation of stage T1b renal cell carcinoma (RCC).Materials And MethodsA retrospective review of a percutaneous renal ablation registry was used to identify 46 patients with a total of 46 biopsy-proven RCC lesions measuring 4.1-7.0 cm treated with cryoablation between 2003 and 2011. The main outcome parameters investigated were adjunctive maneuvers, complications, and local tumor progression, and cancer-specific survival rates. Complication rates were categorized and recorded using the Clavien-Dindo classification system. Progression-free and cancer-specific survival rates were estimated using the Kaplan-Meier method.ResultsThe mean treated RCC size was 4.8 cm (range, 4.1-6.4 cm). Prophylactic tumor embolization was performed in 7 patients (15%), ipsilateral ureteral stents were placed in 7 patients (15%), and hydrodisplacement of bowel was performed in the treatment of 16 tumors (35%). A single technical failure (2.2%) was observed at the time of ablation. Thirty-six tumors (78%) had follow-up imaging at 3 months or later following ablation, including a single recurrence at 9 months after ablation. The mean duration of follow-up for the 35 RCC tumors that did not recur was 2.0 years (range, 0.3-6.1 y). Estimated local progression-free survival rate at 3 years was 96.4%. Of the 46 cryoablation procedures, there were 7 complications (15.2%) of grade II or worse.ConclusionsThe results suggest that cryoablation represents a valid treatment alternative for select patients with clinical stage T1b RCC. Complications are frequent enough that multidisciplinary patient management should be considered.Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

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