Gianpiero Cardone MD, Presenter: Nothing to Disclose

Andrea Cestari MD, Abstract Co-Author: Nothing to Disclose

Luciano Nava MD, Abstract Co-Author: Nothing to Disclose

Giorgio Guazzoni MD, Abstract Co-Author: Nothing to Disclose

Paola Mangili PhD, Abstract Co-Author: Nothing to Disclose

Giuseppe Balconi MD, Abstract Co-Author: Nothing to Disclose

This study aims to determine the safety and efficacy of LC in the management of small renal carcinomas and assess its medium term outcome.

67 pts underwent LC of 82 renal carcinomas between July 2000 and December 2007. All treatment was administered under laparoscopic US guidance. Pts were followed up clinically, biochemically and by MR imaging 24 hours after surgery, and subsequently at 1, 3, 6, 12, 18, 24, 36, 48, 60 and 84 months. All MR examinations were performed with a 1.5T MR system using GRE T1w, TSE T2w and contrast-enhanced dynamic GRE FS-T1w sequences.

24 hours after treatment all cryolesions were more than 1 cm larger than the original masses; cryolesions decreased in size by an average of 38% at 1 month, 46% at 3 months, 64% at 6 months, 80% at 12 months and 93% at 84 months following cryoablation. Early postprocedural MR ce-T1w images showed complete ischemia of cryolesions. Follow-up (mean 49 months, range 6 to 84 months) revealed no evidence of local recurrence in 65/67 pts (97%). 2 pts showed local recurrence at 12 and 24 months. 8/67 (12%) pts demonstrated metachronous nodules in the same or in the contralateral kidney at 12, 18 and 24 months. One pt with local recurrence and 3 pts with metachronous nodules were treated again with cryotherapy. 2 pts showed a pancreatic metastatic nodule at 12 and 24 months. 7/67 pts died for metastasis of a previous malignancy. No significant rise in creatinine level was noted postprocedurally. After surgery 21% of the cases showed a small intralesional haematoma. On 11% of the cases a small perilesional haematoma was evident at 1 and 3 months after surgery.

Our medium term experience suggests that LC is a safe, well tolerated and minimally invasive therapy for small renal carcinomas, and MR is an effective imaging technique in the follow-up of renal lesions treated with LC. A limit of LC is the difficulty to perform repeated treatments in the same kidney.

LC is a safe and minimally invasive therapy for small renal carcinomas and MR is an effective imaging technique in the follow-up of renal lesions treated with LC

Cardone, G, Cestari, A, Nava, L, Guazzoni, G, Mangili, P, Balconi, G, Laparoscopic Cryoablation (LC) of Renal Carcinomas: Medium Term Outcome after 7 Years MR Imaging Follow-up.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6007281.html