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Keywords:

  • renal tumours;
  • percutaneous image-guided ablation;
  • percutaneous cryoablation

Objective

  • To evaluate the technical and oncological efficacy of an image-guided cryoablation programme for renal tumours.

Patients and Methods

  • A prospective analysis of technical and radiological outcomes was undertaken after treatment of 171 consecutive tumours in 147 patients.
  • Oncological efficacy in a subset of 125 tumours in 104 patients with >6 months' radiological follow-up and a further subset of 62 patients with solitary, biopsy-proven renal carcinoma was also analysed.
  • Factors influencing technical success, as determined by imaging follow-up, and complication rates were statistically analysed using a statistics software package and logistic regression analyses.

Results

  • No variables were found to predict subtotal treatment, although gender (P = 0.08), tumour size of >4 cm (P = 0.09) and central location of tumour (P = 0.07) approached significance.
  • Upper pole location was the single variable that was found to predict complications (P = 0.006).
  • Among the 104 patients (125 tumours), radiologically assessed at ≥6 months and with a mean radiological follow-up of 20.1 months, we found a single case of unexpected late local recurrence.

Conclusion

  • Percutaneous image-guided cryoablation, at a mean of 20.1 months' follow-up, appears to provide a safe and effective treatment option with a low complication rate.
  • Anteriorly sited tumours should not be considered a contraindication for percutaneous image-guided cryoablation.