Gianpiero Cardone MD, Presenter: Nothing to Disclose

Cristiana Iabichino, Abstract Co-Author: Nothing to Disclose

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

Massimo Lazzeri MD, , Abstract Co-Author: Nothing to Disclose

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

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

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

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

00030490-DMT et al, 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 to assess its medium term (8 years) outcome.

85 pts underwent LC of 96 renal carcinomas. The entire treatment was administered under laparoscopic US guidance. Pts were followed up clinically, biochemically and by imaging 24 hours after surgery, and subsequently at 1, 3, 6, 12, 18, 24, 36, 48, 60 and 84 months. Imaging follow-up was obtained using a 1,5T MR system in 76 cases and using CT in 9 pts with contraindications to MR.

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, 64% at 6 months, 80% at 12 months and 93% at 84 months following LC. Early postprocedural MR and CT ce- images showed complete ischemia of cryolesions. Follow-up revealed no evidence of local recurrence in 83/85 pts (97%). 2 pts showed local recurrence at 12 and 24 months. 9/85 pts (9%) demonstrated metachronous nodules in the same or in the contralateral kidney at 12, 24 and 48 months. 2 pts showed a pancreatic metastatic nodule at 12 and 24 months. 9/85 pts died for metastasis of a previous malignancy. No significant rise in creatinine level was noted postprocedurally. After surgery 21% of the cases showed small intralesional or perilesional haematomas.

Our experience suggests that LC is a safe, well tolerated and minimally invasive therapy for small renal carcinomas. MR is an effective tool in the imaging follow-up of renal lesions treated with LC, and the high contrast resolution of MR allows a better evaluation of vascularization of treated areas on subtracted ce images compared to CT. CT can be used as an alternative choice to MR, but lower contrast resolution of CT to MR makes it difficult to differentiate the cryolesion from the surrounding perilesional collections. A limit of LC is the difficulty to perform repeated treatments in the same kidney.

LC is a safe, well tolerated and minimally invasive therapy for small renal carcinomas. MR and CT are effective imaging techniques in the follow-up of renal lesions treated with LC.

Cardone, G, Iabichino, C, Nava, L, Lazzeri, M, Cestari, A, Mangili, P, Guazzoni, G, Balconi, G, et al, 0, Laparoscopic Cryoablation (LC) of Renal Carcinomas: Medium Term Outcome after 8 Years CT and MR Imaging Follow-up.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8007312.html