title: Percutaneous computerized tomography guided cryoablation for localized renal cell carcinoma: factors influencing success.
abstract: OBJECTIVE
  We evaluated the factors that influenced the initial success rate and complication rate of percutaneous computerized tomography guided cryoablation of localized renal cell carcinoma of clinical stage T1N0M0.
  
  
  METHODS
  A total of 21 patients with a mean age of 71.5 years and a pathological diagnosis of renal cell carcinoma were treated with percutaneous computerized tomography guided cryoablation under conscious sedation on an outpatient basis. We retrospectively reviewed clinical data, tumor characteristics, techniques and results. Tumors with complete loss of contrast enhancement were considered successfully treated.
  
  
  RESULTS
  A total of 21 patients with 23 tumors underwent 25 cryoablation sessions. The mean intraoperative computerized tomography scan tumor size was 2.1 cm (range 0.5 to 4.3) and the mean ice ball size was 4.1 cm (range 2.2 to 7.2). Of the patients 82.6% (19 of 23) had a single treatment. Patients were followed with postoperative scans of 4.6 to 18.3 months (mean 12.3). There were 2 recurrences. The rate of successful complete tumor ablation was influenced by various factors. Tumor location and size were the major determinants for achieving tumor eradication.
  
  
  CONCLUSIONS
  Percutaneous renal cryoablation using computerized tomography imaging proved to be a successful technique for guiding probe placement and monitoring ice ball formation. Patient selection based on tumor size and location may aid in improved outcomes. Further study and followup are necessary to determine long-term oncological efficacy.
authors.affiliation: Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, Maryland, USA.
authors.forename: Sompol
authors.initials: S
authors.lastname: Permpongkosol
authors.forename: Richard E
authors.initials: RE
authors.lastname: Link
authors.forename: Louis R
authors.initials: LR
authors.lastname: Kavoussi
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Solomon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000601:surgery*; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014057:Tomography, X-Ray Computed