Matthew Suberlak BS, Presenter: Nothing to Disclose

Rendon C. Nelson MD, Abstract Co-Author: Consultant, General Electric Company Research support, Bracco Group Research support, Becton, Dickinson and Company Speakers Bureau, Siemens AG

David Richard Sopko MD, Abstract Co-Author: Nothing to Disclose

Decreased renal function is a known complication of cryoablation. The purpose of our study was to retrospectively evaluate the effects of percutaneous cryoablation (PCA) on renal function in patients with history of previous total/partial nephrectomy or percutaneous renal ablation.

IRB approval was obtained in this HIPAA compliant retrospective study.  We analyzed the medical records of 25 patients who underwent PCA for renal cell carcinoma (RCC) at our institution between November 2005 and May 2009, and had at least 6 months post-procedure follow-up. Inclusion criteria were prior nephrectomy or prior renal ablative procedure (radiofrequency or cryoablation). Patient demographics, tumor characteristics (size, location, number of lesions), renal function parameters (serum creatinine, glomerular filtration rate (GFR), chronic kidney disease (CKD) classification), and procedural complications were recorded. Axial tumor dimensions were obtained from CT or MRI using a GE PACS workstation. Coronal dimensions were also reviewed on PACS or reconstructed on a Vitrea 3D workstation. Postoperatively, patients were evaluated by laboratory measurements at 6 and 12 months and accompanying serial CT or MRI.

We found 25 patients matching our criteria (10 nephrectomy; 15 percutaneous intervention). Median age was 58, 76% were Caucasian, 72% males. Median BMI and lesion size were 28.9kg/m2 and 1.9cm, respectively. Follow up data was available in 23 of 25 patients.  Preoperative and postoperative serum creatinine were 1.45 and 1.5 mg/dL respectively (p=0.246) with a median change of +0.1mg/dL. Preoperative and postoperative CKD classifications remained stable in 19 and progression of CKD was observed in 2 patients. No patients required initiation of hemodialysis.  There was no statistically significant change in renal function noted between the nephrectomy or percutaneous patients on subgroup analysis.

We demonstrate no statistically significant detrimental mid-term effect on renal function in patients with prior surgery or percutaneous treatment.  Further investigation will be required to delineate the long-term impact in these patients.

The lack of effects of percutaneous cryoablation on renal function suggests that it is a useful treatment in patients with a history of renal procedures.

Suberlak, M, Nelson, R, Sopko, D, Safety and Mid-term Effects of Percutaneous Cryoablation on Renal Function in Patients with Prior Partial/Total Nephrectomy or Previous Renal Cryoablation.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9013046.html