CT-guided cryoablation safe for kidney lesions

Friday, December 3 | 10:30 a.m.-10:40 a.m. | SST16-01 | Room E353B
There's more than one way to kill a kidney cancer without surgery. Freezing renal tumors percutaneously is safe and effective and delivers very low complication rates, say researchers from Duke University in Durham, NC.

Michael Rosenberg will present research headed by Charles Kim, MD, that treated 107 patients with renal masses suspicious for renal cell carcinoma (71 men, 36 women; mean age, 64) with CT-guided percutaneous cryoablation.

The team reviewed CT images before, during, and after the procedure, measuring tumor size and ice ball overlap with the sinus. A medical records search along with follow-up imaging was performed to look for significant hemorrhage requiring intervention or evidence of collecting system injury such as urinoma, local collecting system stricture, or fistulous tract, the authors will report. The mean follow-up was 9.3 months (range, 0-45 months).

The mean diameter of ablated lesions was 2.2 cm (range, 0.8-5.7). In 67 cases, the ice ball "abutted or involved the renal sinus," the authors wrote in their abstract. Mean tumor diameter was significantly higher for central ice balls (2.5 cm) versus noncentral (1.9 cm, p < 0.001).

No cases of collecting system injury were found, but a hemorrhagic complication required intervention. A noncentral ablation of a 1.4-cm tumor required subsequent percutaneous embolization. Overall, however, in CT-guided percutaneous cryoablation of renal masses where the ice ball abuts or overlaps the renal sinus, the study found no cases of collecting system injuries or significant hemorrhagic complications.

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