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. 2023 Oct 3:13:1235705.
doi: 10.3389/fonc.2023.1235705. eCollection 2023.

Efficacy and safety of cryoablation for localized renal tumor as an alternative approach to partial nephrectomy

Irène Barjolle  1 , Loic Ah-Thiane  2 , Eric Frampas  1 , Georges Karam  3 , Jérôme Rigaud  3 , Arthur David  1
Affiliations

Efficacy and safety of cryoablation for localized renal tumor as an alternative approach to partial nephrectomy

Irène Barjolle et al. Front Oncol. .

Abstract

Introduction: Renal cryoablation displays a profile of high tolerance, including in a frail population. Cryoablation appears as a validated alternative treatment to surgery for renal tumors smaller than 4 cm. However, evidence is lacking for larger tumors, despite encouraging data for tumors up to 7 cm.

Material and methods: This retrospective descriptive study of a population with a stage T1b renal tumor treated by cryoablation was conducted at the Nantes University Hospital between January 2009 and July 2021. Primary endpoint was 3-year rate of local recurrence. Secondary endpoints included technical efficacy, overall and cancer-specific survivals, and safety assessment.

Results: A total of 63 patients were analyzed. Three-year rate of local recurrence was 11.1%. Primary and secondary technical efficacies were achieved in 88.9% and 96.8% of patients, respectively, and 3-year overall and cancer-specific survival were 87.3% and 95.2%, respectively. Most patients (73%) experienced no complications, 13% of patients had minor (CIRSE grades 1 or 2) adverse effects, and 13% had severe but non-lethal (CIRSE grade 3) adverse effects. One patient died following cryoablation due to colic perforation. The most common AE (all grades) was hemorrhage (9.5%).

Discussion: This study showed a good efficacy and safety of cryoablation for renal tumors up to 7 cm (T1b). Our results were consistent with a rather sparse literature and contributed to guide future recommendations about cryoablation as an alternative to surgery for T1b renal tumors.

Keywords: T1b renal tumor; cryoablation; interventional radiology; localized renal cancer; partial nephrectomy; renal tumor.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Pre- and per-procedure images of renal cryoablation. (Left picture) CT scan showing a left renal mass of 42 mm to treat (see arrow). (Right picture) Visualization of the inserted cryoprobes and the ice ball clearly circumscribing the tumor lesion.
Figure 2
Figure 2
Post-procedure magnetic resonance imaging. (Left picture) The right upper polar cryoablation zone (see arrow) is in discreetly heterogeneous T2 hyposignal. (Right picture) T1 sequence injected at subtracted arterial time showing no nodular enhancement over the cryoablation area (see arrow).
Figure 3
Figure 3
Local recurrence. The Kaplan–Meier curve displays the estimate of local recurrence-free survival (LRFS).
Figure 4
Figure 4
Overall survival and cancer-specific survival. The Kaplan–Meier curve (A) displays the estimate of overall survival (OS). The Kaplan–Meier curve (B) displays the estimate of cancer-specific survival (CSS).
See this image and copyright information in PMC

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