Peter John Littrup MD, Abstract Co-Author: Consultant, Endocare, Inc Research support, Endocare, Inc

Hussein D. Aoun MD, Presenter: Nothing to Disclose

Barb Adam BA, Abstract Co-Author: Nothing to Disclose

Cryotherapy has lower procedure pain, good visibility and healing. We assessed the clinical and imaging outcomes of percutaneous cryotherapy for primary renal tumors beyond 12 months, in relation to tumor size and location.

Ninety-eight CT fluoroscopic-guided, percutaneous cryoablations were performed on 100 masses in 90 outpatients. Percutaneously placed 2 cm esophageal dilatation balloons (N=4) or percutaneous local saline injection (N=23) acted as insulation barriers for adjacent bowel. Patients were followed by either CT or MRI at 1, 3, 6, 12, 18, 24 and 36 months and complications were graded according to Common Toxicity Criteria for Adverse Events Version 3.0 (CTCAE) of the National Cancer Institute.

All patients required minimal sedation during the procedure and were discharged with minimal discomfort within 4-6 hours. The hypodense cryotherapy zone was well defined with an average diameter of 5 cm, while average tumor size was 3.1 cm. Major grade >3 and self-limited minor complications occurred following 3 (3%) and 14 (14%) procedures, respectively. At a mean follow-up of 1.3 years, 47 patients had follow-up >12 months and the longest 56 months. Four RCC recurrences (4%) were related to either equipment failure, multi-focal tumor (VHL), or warming by adjacent liver respiratory movements.

Percutaneous renal cryotherapy is a well-tolerated, technically feasible and effective outpatient procedure that allows CT monitoring of ice formation well beyond tumor margins. Central components, or large tumors, do not appear to preclude thorough treatment, or pose greater complication risks with appropriate probe placement and protective measures.

Presentation Preference: Paper Category: Kidney/Bladder/Prostate  

Littrup, P, Aoun, H, Adam, B, Percutaneous Cryotherapy of Renal Cell Carcinoma (RCC): Low Complication and Recurrence Rates beyond 12 months.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6021874.html