title: Prospective study of ultrasound-guided percutaneous renal cryotherapy: case selection as an optimization factor for a technique.
abstract: OBJECTIVE
  To evaluate the technical and oncological effectiveness of ultrasound-guided percutaneous renal cryotherapy (PRC) in a selected group of patients with renal cancer.
  
  
  METHODS
  We conducted a prospective study of 28 patients with posterior-facing T1a renal tumors with middle and inferior external borders. All patients underwent ultrasound-guided PRC. Follow-up was conducted with computed tomography at 1 month and then every 6 months, with a good result defined as the total absence of contrast incorporation. We performed a descriptive and survival study using the Kaplan-Meier estimator.
  
  
  RESULTS
  The 28 patients had a mean age (SD) of 68.3 (10.1) years, and the group underwent 28 procedures. The mean (SD) size of the tumors was 25.5 (7.5) mm, the mean nephrometry score was 1.41 (0.52) and the mean preoperative creatinine level was 133.5 (144.1) mmol/L. There were no intraoperative complications. In terms of postoperative complications, there was only 1 case (3.5%) of a skin lesion resulting from treating a tumor in a transplanted kidney (Clavien II). The median follow-up was 25 months, and the mean (SD) postoperative creatinine level was 135.5 (110.3) mmol/L. Two cases presented radiological recurrence (93% efficacy), with a mean time to recurrence of 12 and 19 months, respectively. There were no tumor-related deaths.
  
  
  CONCLUSIONS
  Our series (the largest on PRC in our country to date) shows that, with an appropriate selection of tumors, PRC is a safe technique with minimal morbidity. Ultrasonography enables the controlled performance of the procedure and saves the patient from radiation and reduces costs.
authors.affiliation: Unidad de Urooncología, Fundació Puigvert, Barcelona, España. Electronic address: orodriguez@fundacio-puigvert.es.
authors.forename: O
authors.initials: O
authors.lastname: Rodríguez-Faba
authors.affiliation: Unidad de Urooncología, Fundació Puigvert, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Palou
authors.affiliation: Unidad de Urooncología, Fundació Puigvert, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Rosales
authors.affiliation: Unidad de Urooncología, Fundació Puigvert, Barcelona, España.
authors.forename: P
authors.initials: P
authors.lastname: de la Torre
authors.affiliation: Servicio de Urología, Fundació Puigvert, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Martí
authors.affiliation: Unidad de Urooncología, Fundació Puigvert, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Palazzetti
authors.affiliation: Unidad de Urooncología, Fundació Puigvert, Barcelona, España.
authors.forename: H
authors.initials: H
authors.lastname: Villavicencio
mesh_terms: D000368:Aged; D017679:Cryotherapy / Q000379:methods*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000628:therapy*; D008297:Male; D018579:Patient Selection; D010537:Peritoneum; D011446:Prospective Studies; D018084:Ultrasonography, Interventional
keywords: Crioterapia; Cryotherapy; Cáncer renal; Ecoguiada; Percutaneous; Percutánea; Renal cancer; Ultrasound-guided