Laparoscopic Renal Cryoablation: Long-Term Oncologic Outcomes With Minimum 5-Year Follow-Up

Main Category: Urology / Nephrology
Also Included In: Cancer / Oncology
Article Date: 14 Jun 2008 - 2:00 PDT

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ORLANDO, FL (UroToday.com) - Ablative therapies for small renal masses have gained popularity over laparoscopic approaches due to the surgical complexity of laparoscopic partial nephrectomy.

Aron and colleagues from the Cleveland Clinic present their 5-10 year oncologic outcomes after laparoscopic renal cryoablation (LRC). Between 09/1997 and 09/2007, they performed renal cryoablation in 288 patients. Of these, 84 patients before 09/2002 had minimum 5-year follow-up.

Follow-up involved MRI imaging on postoperative day 1, 3 months, 6 months, 12 months, and then annually, with biopsy of the renal lesion at 6-months. In the 84 patients with minimum 5-year follow-up, the mean age was 67 years, 82 patients had a sporadic single renal mass, 6 had multiple lesions, mean tumor size was 2.3 cm (0.9-5.0 cm), median ASA score was III, and mean BMI was 28. Overall, 5 patients developed local recurrence (1 of these had multiple tumors at initial presentation), 2 had local recurrence with metastases, and 7 had distant metastases without local recurrence (1 of these had multiple tumors at initial presentation). Overall, there were 7 cancer deaths, 6 of these in patients with a sporadic single mass at presentation. In the 82 patients with sporadic single renal mass (median follow-up 83 months; range 60-120 months), 5-year actual overall, cancer-specific, and disease-free survival is 83%, 95%, and 78%, respectively, while 10-year Kaplan-Meier overall, cancer-specific, and disease-free survival are 57%, 88%, and 51%, respectively.

This is one of the largest long term follow up studies on renal mass cryoablation, and the results thus far appear promising. However, further studies regarding the optimal follow up method for these lesions and the optimal application of the technique still need to be performed.

Moderated by: H. Barton Grossman, MD and Khaled Hafez, MD, at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday.com Contributing Editor Michael K. Louie, MD

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