TY - JOUR
T1 - Percutaneous Cryoablation of Solitary, Sporadic Renal Cell Carcinoma
T2 - Outcome Analysis Based on Clear-Cell versus Papillary Subtypes
AU - Haddad, Mustafa M.
AU - Schmit, Grant D.
AU - Kurup, A. Nicholas
AU - Schmitz, John J.
AU - Boorjian, Stephen A.
AU - Geske, Jennifer
AU - Thompson, R. Houston
AU - Callstrom, Matthew R.
AU - Atwell, Thomas D.
N1 - Publisher Copyright:
© 2018 SIR
PY - 2018/8
Y1 - 2018/8
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85048212054&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85048212054&partnerID=8YFLogxK
U2 - 10.1016/j.jvir.2018.02.029
DO - 10.1016/j.jvir.2018.02.029
M3 - Article
C2 - 29887184
AN - SCOPUS:85048212054
SN - 1051-0443
VL - 29
SP - 1122
EP - 1126
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 8
ER -