title: Safety and efficacy of CT-guided percutaneous cryoablation for renal cell carcinoma.
abstract: OBJECTIVE
  Image-guided percutaneous cryoablation is a treatment alternative for selected patients with renal cell carcinoma (RCC). The objective of the present study was to present the safety and efficacy of percutaneous cryoablation.
  
  
  METHODS
  The study included 51 lesions in 46 consecutive patients treated with computed tomography (CT)-guided percutaneous cryoablation. Results were based on 40 RCCs with follow-up. Patients had baseline history and physical and laboratory examinations and renal CT or magnetic resonance (MR) imaging and were followed every 3 months. Biopsy of all lesions was performed before or at the time of the procedure. Efficacy was defined as a complete lack of enhancement on follow-up contrast agent-enhanced CT or MR imaging. Lesion size was also followed and correlated with lack of enhancement. Short- and long-term complications were tabulated.
  
  
  RESULTS
  The technical success rate was 100%, with 20% of cases requiring some form of thermal protection of an adjacent organ. During follow-up (median, 28 weeks; range, 4-81 weeks), the efficacy rate was 100% for lesions smaller than 7 cm. The incidence of significant complications was 18% (8% CTAE), mostly (10%) intercostal or genitofemoral nerve injury. All patients with complications recovered fully, and there were no mortalities. There was no change in creatinine levels, and no patient developed renal failure as a result of cryoablation.
  
  
  CONCLUSIONS
  CT-guided percutaneous cryoablation resulted in complete response for lesions as large as 4 cm. It may also be a viable alternative for nonsurgical candidates with lesions as large as 7 cm. It has a high efficacy rate, and its modest complications are not only comparable to those of other treatment modalities, but also appear to be reversible.
authors: Department of Vascular Interventional Radiology, Johns Hopkins Hospital, 600 North Wolfe Street, Blalock 544, Baltimore, MD 21287, USA. g_christos@hotmail.com
authors: Christos S
authors: CS
authors: Georgiades
authors: Kelvin
authors: K
authors: Hong
authors: Cary
authors: C
authors: Bizzell
authors: Jean-Francois
authors: JF
authors: Geschwind
authors: Ronald
authors: R
authors: Rodriguez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D003452:Cryosurgery / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome