Clinical experience with open renal cryoablation.
Rukstalis DB, Khorsandi M, Garcia FU, Hoenig
DM, Cohen JK.
Department of Surgery, Division of Urology,
MCP Hahnemann University, School of Medicine, Philadelphia, Pennsylvania,
OBJECTIVES: To evaluate the safety and efficacy
of open renal cryoablation of small solid renal masses, since the
delivery of freezing temperatures has been shown to effectively
ablate solid neoplasms of the liver, uterus, and prostate. METHODS:
A total of 29 patients were treated with open renal cryoablation
since December 1996 and followed up to evaluate the treatment safety
and initial radiographic response. RESULTS: The median preoperative
lesion size was 2.2 cm, with 22 solid renal masses and 7 complex
renal lesions. Five serious adverse events occurred in 5 patients,
with only one event directly related to the procedure. One patient
experienced a biopsy-proven local recurrence, and 91.3% of patients
(median follow-up 16 months) demonstrated a complete radiographic
response with only a residual scar or small, nonenhancing cyst.
CONCLUSIONS: Open renal cryoablation appears to be a safe technique
for the in situ destruction of solid or complex renal masses. However,
inadequate freezing of renal cell carcinoma may result in local
disease persistence. The expected slow growth rate of small renal
cancers necessitates prolonged radiologic follow-up. Continued clinical
research is required before renal cryoablation can be considered
an acceptable curative treatment for renal cancer.