Is cryoablation a valid option for renal cell carcinomas in direct contact with critical organs?

Abstract

Purpose

This study aimed to assess the outcomes of percutaneous cryoablation (PCA) for renal cell carcinomas (RCCs) contacting critical organs without intervening fat tissue.

Material and methods

Twenty-three patients with 24 RCCs (mean size, 28.8 mm) contacting critical organs on preprocedural images were included. The organ displacement techniques, technical success, efficacy, and adverse events per Clavien–Dindo classification were retrospectively reviewed.

Results

The organs contacting the RCCs included the colon (n = 16), pancreas (n = 3), duodenum (n = 3), small intestine (n = 1), and stomach (n = 1). In all procedures, hydrodissection was conducted, and probe traction was additionally utilized in one to displace organs. Two procedures were terminated with an insufficient ice-ball margin (<6 mm) due to recurring proximity of the colon or thermal sink effect by renal hilar vessels, yielding a technical success rate of 91.6% (22/24). No severe adverse events were noted. All patients were alive without any metastases during a median follow-up of 34.4 months. The primary and secondary technical efficacy rates were 91.6% (22/24) and 95.8% (23/24) of tumors, respectively.

Conclusion

PCA can be a valid option for RCCs contacting critical organs with a good safety profile and sufficient technical efficacy.

Keywords:

• Cryoablation
• displacement technique
• hydrodissection
• renal cell carcinoma
• cryoinjury

Acknowlegments

The preliminary work of this study was presented at the 82nd annual meeting of the Japan Radiological Society.

Ethical statement

This study was approved by the relevant ethics committee (approval number, KEN 2210-010), and opt-out consent was obtained for the retrospective use of medical patient data. The study was performed per the ethical standards as laid down in the 1964 Declaration of Helsinki. This report does not contain any personal information that could lead to the identification of the patients.

Disclosure statement

Y.M. and T.H. received a lecturer’s fee from Boston Scientific Japan outside this work. The other authors have no relevant conflicts of interest to disclose.

Data availability statement

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

Additional information

Funding

This study was not supported by any funding.