Cryoablation Effective for Small Renal Masses

By Will Boggs, MD

NEW YORK OCT 18, 2007 (Reuters Health) - Cryoablation is an effective treatment option for patients with small renal masses, according to a report in the October issue of BJU International.

Senior investigator Dr. Stephen Y. Nakada from the University of Wisconsin, Madison, told Reuters Health that physicians should "consider cryoablation in cases of small renal tumors."

Dr. Nakada and colleagues report their 5-year experience with 78 patients who underwent laparoscopic or percutaneous cryoablation for small renal masses.

The final pathology in 44 patients included 24 renal cell carcinomas (55%), 13 benign renal tissue or nonspecific findings (30%), and 7 oncocytomas (15%).

In 95% of the cases, the lesion was ablated in one operative setting, the authors report. Three patients required repeat cryoablation, and one patient underwent a radical nephrectomy.

After a mean follow-up of 19 months, 7 patients with laparoscopic cryoablation and 2 with percutaneous cryoablation died from causes unrelated to their renal masses, for an overall survival rate of 88.5% and a cancer-specific survival rate of 100%.

One patient developed a local recurrence at the ablation site, the investigators say, resulting in a recurrence-free survival rate of 98.7%.

Overall, there were four complications during cryoablation and seven afterwards, the report indicates.

Dr. Nakada said that cryoablation was most appropriate for renal masses smaller than 4 cm diameter.

"We think that it was advantageous to collaborate with a dedicated uroradiologist to improve the image guidance of the ablation, and thus achieve optimum results," the researchers note.

SOURCE:

• BJU Intl 2007;100:798-801.