title: Laparoscopic cryoablation for clinical stage T1 renal masses: long-term oncologic outcomes at the Medical College of Wisconsin.
abstract: OBJECTIVE
  To report the long-term oncologic outcomes of laparoscopic cryoablation for clinical stage T1 renal masses at the Medical College of Wisconsin.
  
  
  METHODS
  A retrospective chart review was performed evaluating patients who underwent laparoscopic cryoablation for renal masses at the Medical College of Wisconsin between February 2000 and October 2009.
  
  
  RESULTS
  A total of 171 renal masses in 144 patients were treated by laparoscopic cryoablation during the study period. After excluding patients with <5 years follow-up and those with >clinical stage I disease, 112 renal masses treated in 92 patients remained for analysis. Mean patient age was 59.6 years (standard deviation [SD], 12.5 years). Mean lesion size was 2.3 cm (SD, 0.94 cm). Mean age adjusted Charlson comorbidity index was 4.55 (SD, 1.69). Mean follow-up was 97.9 months (SD, 24.8 months). Overall survival among all patients was 80.9%. Lesions were biopsy proven to be malignant in 70 patients (76.3%). Of those with biopsy-proven malignancy, there were 6 recurrences, 14 non-cancer-related deaths, and 1 cancer-related death, leading to an overall survival of 77.6%, progression-free survival of 91.0%, and cancer-specific survival of 98.5%.
  
  
  CONCLUSIONS
  We report the largest published series of laparoscopic renal cryoablation with the longest follow-up. Our series indicates that laparoscopic cryoablation is both an efficacious treatment for clinical stage T1 renal masses and provides excellent long-term oncologic outcomes.
authors.affiliation: Department of Urology, Medical College of Wisconsin, Milwaukee, WI. Electronic address: scjohnson@mcw.edu.
authors.forename: Scott
authors.initials: S
authors.lastname: Johnson
authors.affiliation: Department of Urology, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Khanh N
authors.initials: KN
authors.lastname: Pham
authors.affiliation: Department of Urology, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: William
authors.initials: W
authors.lastname: See
authors.affiliation: Department of Urology, Ohio State University, Columbus, OH.
authors.forename: Frank P
authors.initials: FP
authors.lastname: Begun
authors.affiliation: Department of Urology, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Peter
authors.initials: P
authors.lastname: Langenstroer
mesh_terms: D000368:Aged; D001706:Biopsy; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000601:surgery*; D003452:Cryosurgery / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D012189:Retrospective Studies; D012371:Robotics; D013997:Time Factors; D016896:Treatment Outcome