Abstract
Objective
To evaluate the safety, efficacy, and oncologic control of percutaneous image-guided
cryoablation in the treatment of completely endophytic renal masses. Percutaneous
image-guided cryoablation is a minimally invasive and effective treatment for small
renal masses. Image-guided cryoablation is an attractive treatment for completely
endophytic tumors given the challenge in visualization of such lesions during surgical
extirpation.
Materials and Methods
A retrospective study evaluating percutaneous cryoablation of completely endophytic
renal masses with normal overlying renal cortex was performed. From January 2003 to
December 2015, 200 endophytic renal masses (RENAL score 3 – endophytic/exophytic)
were identified from an internal renal ablation database. After imaging review, 49
tumors with completely intact overlying renal cortex in 47 patients were included
in the study. Outcomes, including complications and oncologic efficacy were evaluated
according to standard nomenclature.
Results
Patients comprised 37 men and 10 women (mean age 64.0 years) who underwent 48 cryoablation
procedures to treat 49 renal masses. Mean tumor size was 2.5 ± 0.5 cm. Major complications
occurred following 5 of the 48 (10%) procedures. Forty of 46 (87%) tumors with imaging
follow-up were recurrence-free at a mean of 56 months. Five of six local recurrences
were successfully retreated with cryoablatoin.
Conclusion
Percutaneous thermal ablation of completely endophytic renal masses is a relatively
safe procedure associated with acceptable complication and local tumor control rates.
Given the complexities associated with partial nephrectomy, percutaneous cryoablation
may be considered an alternative treatment for these select patients. Long-term follow-up
studies are necessary to determine the durable efficacy of this treatment.
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Article info
Publication history
Published online: August 12, 2019
Accepted:
August 5,
2019
Received:
May 13,
2019
Footnotes
Financial Disclosure: All authors have nothing to disclose and no financial disclosure.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
