title: The impact of renal tumor size on the efficacy of laparoscopic renal cryoablation.
abstract: OBJECTIVE
  We evaluated the impact of renal tumor size on the oncologic and surgical efficacy of laparoscopic renal cryosurgery (LRC) according to our intermediate-term experience in Korea.
  
  
  METHODS
  From June 2005 to October 2008, we enrolled 37 patients who underwent LRC for 40 renal tumors. Patients were stratified into four groups according to renal tumor size. Patients who presented with a maximum tumor diameter (MTD) of at least 1 cm but less than 2 cm were assigned to Group 1, those with an MTD equal to or greater than 2 but less than 3 cm were assigned to Group 2, those with an MTD equal to or greater than 3 but less than 4 cm were assigned to Group 3, and those with an MTD equal to or greater than 4 cm were assigned to Group 4. Oncologic and clinical outcomes in each group were compared.
  
  
  RESULTS
  The four groups showed no statistically significant differences in preoperative variables, including age, sex, body mass index, American Society of Anesthesiologists scores, baseline renal function and hemoglobin, and length of hospital stay. Regarding surgical aspects, however, operation time, estimated blood loss, and postoperative complications were significantly increased in patients with larger tumors. Three patients in Group 3 required postoperative transfusions, and 1 patient in Group 4 required conversion to open renal cryosurgery. During the mean follow-up period of 31.6 months, radiologic evidence of tumor recurrence was found in only 2 patients in Group 4.
  
  
  CONCLUSIONS
  In this series, LRC for renal tumors smaller than 3 cm was conducted safely without radiologic evidence of tumor recurrence during intermediate-term follow-up. For tumors larger than 3 cm, however, the transfusion rate increased, and for renal tumors larger than 4 cm, the tumor recurrence rate increased significantly.
authors.affiliation: Department of Urology, Korea University School of Medicine, Seoul, Korea.
authors.forename: Byeong Kuk
authors.initials: BK
authors.lastname: Ham
authors.forename: Sung Gu
authors.initials: SG
authors.lastname: Kang
authors.forename: Hoon
authors.initials: H
authors.lastname: Choi
authors.forename: Young Hwii
authors.initials: YH
authors.lastname: Ko
authors.forename: Seok Ho
authors.initials: SH
authors.lastname: Kang
authors.forename: Jun
authors.initials: J
authors.lastname: Cheon