title: Percutaneous renal cryoablation in obese and morbidly obese patients.
abstract: OBJECTIVE
  To compare percutaneous renal cryoablation complications and outcomes in obese and morbidly obese vs nonobese patients.
  
  
  METHODS
  Three hundred eighty-nine percutaneous cryoablation procedures were performed in 367 patients for treatment of 421 renal masses at our institution between 2003 and 2012. Patients were categorized into 3 groups on the basis of body mass index (BMI): nonobese (BMI <30.0 kg/m(2)), obese (BMI 30.0-39.9 kg/m(2)), and morbidly obese (BMI ≥40.0 kg/m(2)). Each group was retrospectively analyzed for major complications (Clavien ≥grade 3) and oncologic outcomes.
  
  
  RESULTS
  One hundred eighty-nine renal cryoablation procedures (48.6%) were performed on nonobese patients, 161 (41.4%) on obese patients, and 39 (10.0%) on morbidly obese patients. Eleven (5.8%) major complications occurred in nonobese patients, 15 (9.3%) in obese patients, and 3 (7.7%) in morbidly obese patients. As such, there was no significant difference in the rate of major complications in obese (P = .23) or morbidly obese (P = .67) compared with nonobese patients. There was 1 ablation-related death from complications of urosepsis. Thirteen local treatment failures were identified, including 5 technical failures and 8 local tumor recurrences during median imaging follow-up of 18 months (interquartile range: 8-36). Six local treatment failures (3.2%) occurred in nonobese patients, 5 (2.9%) in obese patients, and 2 (4.8%) in morbidly obese patients. Again, no significant difference was noted in local treatment failure rate between obese (P = .96) or morbidly obese (P = .57) compared with nonobese patients.
  
  
  CONCLUSIONS
  Percutaneous renal cryoablation complication rates and short-term outcomes in obese and morbidly obese patients are similar to those in nonobese patients.
authors.affiliation: Department of Radiology, Mayo Clinic, School of Medicine, Rochester, MN, USA. schmit.grant@mayo.edu
authors.forename: Grant D
authors.initials: GD
authors.lastname: Schmit
authors.forename: R Houston
authors.initials: RH
authors.lastname: Thompson
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Boorjian
authors.forename: Robert J
authors.initials: RJ
authors.lastname: McDonald
authors.forename: A Nicholas
authors.initials: AN
authors.lastname: Kurup
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Weisbrod
authors.forename: Daryl J
authors.initials: DJ
authors.lastname: Kor
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Callstrom
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Atwell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000601:surgery*; D003452:Cryosurgery / Q000009:adverse effects*; D018572:Disease-Free Survival; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D007680:Kidney Neoplasms / Q000150:complications / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009403:Nephrostomy, Percutaneous; D009765:Obesity / Q000150:complications*; D009767:Obesity, Morbid / Q000150:complications; D012189:Retrospective Studies; D017211:Treatment Failure; D055815:Young Adult