title: Percutaneous cryoablation of renal tumours: outcomes from 171 tumours in 147 patients.
abstract: OBJECTIVE
  To evaluate the technical and oncological efficacy of an image-guided cryoablation programme for renal tumours.
  
  
  METHODS
  A prospective analysis of technical and radiological outcomes was undertaken after treatment of 171 consecutive tumours in 147 patients. Oncological efficacy in a subset of 125 tumours in 104 patients with >6 months' radiological follow-up and a further subset of 62 patients with solitary, biopsy-proven renal carcinoma was also analysed. Factors influencing technical success, as determined by imaging follow-up, and complication rates were statistically analysed using a statistics software package and logistic regression analyses.
  
  
  RESULTS
  No variables were found to predict subtotal treatment, although gender (P = 0.08), tumour size of >4 cm (P = 0.09) and central location of tumour (P = 0.07) approached significance. Upper pole location was the single variable that was found to predict complications (P = 0.006). Among the 104 patients (125 tumours), radiologically assessed at ≥6 months and with a mean radiological follow-up of 20.1 months, we found a single case of unexpected late local recurrence.
  
  
  CONCLUSIONS
  Percutaneous image-guided cryoablation, at a mean of 20.1 months' follow-up, appears to provide a safe and effective treatment option with a low complication rate. Anteriorly sited tumours should not be considered a contraindication for percutaneous image-guided cryoablation.
authors.affiliation: Department of Radiology, University Hospitals of Southampton NHS Foundation Trust, Southampton, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Breen
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Bryant
authors.forename: Ausami
authors.initials: A
authors.lastname: Abbas
authors.forename: Beth
authors.initials: B
authors.lastname: Shepherd
authors.forename: Neil
authors.initials: N
authors.lastname: McGill
authors.forename: Jane A
authors.initials: JA
authors.lastname: Anderson
authors.forename: Richard C
authors.initials: RC
authors.lastname: Lockyer
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Hayes
authors.forename: Steve L
authors.initials: SL
authors.lastname: George
mesh_terms: D000368:Aged; D001706:Biopsy; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011446:Prospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
keywords: percutaneous cryoablation; percutaneous image-guided ablation; renal tumours