title: Image-guided percutaneous renal cryoablation for stage 1 renal cell carcinoma with high surgical risk.
abstract: BACKGROUND
  This study was undertaken to evaluate the feasibility, safety, and therapeutic effects of percutaneous renal cryoablation under local anesthesia with conscious sedation for patients who have unresectable stage 1 (T1NoMo) renal cell carcinoma (RCC) in high surgical risk.
  
  
  METHODS
  Eighteen patients who were not candidates for surgery underwent primary cryosurgery guided by gray-scale ultrasound. Contrast-enhanced ultrasonography (CEUS) and contrast-enhanced computed tomography (CT) were performed to evaluate treatment at completion.
  
  
  RESULTS
  The mean follow-up period was 26.8 months (range, 12-56 months). All tumors were biopsied before cryosurgery. Seventeen tumors remained free of enhancement during follow-up period. No major complications associated with cryoablation procedures were found though two instances of subcapsular hematomas, one of retroperitoneal errhysis and one of nausea, were seen after cryoablation. One patient had a local recurrence of tumor and received additional cryoablation. Local tumor control rate was 100 % of T1NoMo tumors including the recurrence case who underwent additional cryoablation.
  
  
  CONCLUSIONS
  Percutaneous cryoablation can be recommended as a feasible, safe, and promising therapy for the treatment of renal tumor, especially those unresectable stage 1 RCC, with a low risk of complications.
authors.affiliation: Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China. enshine@163.com.
authors.forename: Xiang
authors.initials: X
authors.lastname: Yan
authors.affiliation: Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China. m007mhero@126.com.
authors.forename: Mingxin
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China. chenxiaoxiang1987@126.com.
authors.forename: Xiaoxiang
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China. wawe9999@163.com.
authors.forename: Wang
authors.initials: W
authors.lastname: Wei
authors.affiliation: Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China. doctoryr@gmail.com.
authors.forename: Rong
authors.initials: R
authors.lastname: Yang
authors.affiliation: Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China. yangynju@126.com.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China. ganweidong@yahoo.cn.
authors.forename: Weidong
authors.initials: W
authors.lastname: Gan
authors.affiliation: Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China. dr.guohongqian@gmail.com.
authors.forename: Hongqian
authors.initials: H
authors.lastname: Guo
authors.affiliation: Department of Radiology, Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China. wangzhang227@163.com.
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Medical School of Nanjing University, Nanjing, China. gshi@rics.bwh.harvard.edu.|Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA. gshi@rics.bwh.harvard.edu.
authors.forename: Guo-Ping
authors.initials: GP
authors.lastname: Shi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D003452:Cryosurgery / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D025321:Surgery, Computer-Assisted / Q000379:methods*