title: Oncological outcomes and complication rates after laparoscopic-assisted cryoablation: a European Registry for Renal Cryoablation (EuRECA) multi-institutional study.
abstract: To assess complication rates and intermediate oncological outcomes of laparoscopic-assisted cryoablation (LCA) in patients with small renal masses (SRMs).
  
  
  
  A retrospective review of 808 patients treated with LCA for T1a SRMs from 2005 to 2015 at eight European institutions. Complications were analysed according to the Clavien-Dindo classification. Kaplan-Meier analyses were used to estimate 5- and 10-year disease-free survival (DFS) and overall survival (OS).
  
  
  
  The median [interquartile (IQR)] age was 67 (58-74) years. The median (IQR) tumour size was 25 (19-30) mm. The transperitoneal approach was used in 77.7% of the patients. The median postoperative hospital stay was 2 days. In all, 514 patients with a biopsy-confirmed renal cell carcinoma (RCC) were available for survival analyses. The median (IQR) follow-up for the RCC-cohort was 36 (14-56) months. A total of 32 patients (6.2%) were diagnosed with treatment failure. The 5-/10-year DFS was 90.4%/80.0% and 5-/10-year OS was 83.2%/64.4%, respectively. A total of 134 postoperative complications (16.6%) were reported, with severe complications (grade ≥III) in 26 patients (3.2%). An American Society of Anesthesiologists score of 3 was associated with an increased risk of overall complications (odds ratio 2.85, 95% confidence interval 1.32-6.20; P = 0.005).
  
  
  
  This large series of LCA demonstrates satisfactory long-term oncological outcomes for SRMs. However, although LCA is considered a minimally invasive procedure, risk of complications should be considered when counselling patients.
authors.affiliation: Department of Urology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Tommy K
authors.initials: TK
authors.lastname: Nielsen
authors.affiliation: Department of Urology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.
authors.forename: Brunolf W
authors.initials: BW
authors.lastname: Lagerveld
authors.affiliation: Bristol Urological Institute, Bristol, UK.
authors.forename: Francis
authors.initials: F
authors.lastname: Keeley
authors.affiliation: Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, Milano, Rozzano, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lughezzani
authors.affiliation: Department of Urology, Darent Vally Hospital, Dartford, UK.
authors.forename: Seshadri
authors.initials: S
authors.lastname: Sriprasad
authors.affiliation: Department of Urology, Frimley Park Hospital, Camberley, UK.
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Barber
authors.affiliation: Department of Urology, Aarhus University Hospital, Aarhus, Denmark.|Department of Urology, Odense University Hospital, Odense, Denmark.
authors.forename: Lars U
authors.initials: LU
authors.lastname: Hansen
authors.affiliation: Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, Milano, Rozzano, Italy.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Buffi
authors.affiliation: Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, Milano, Rozzano, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Guazzoni
authors.affiliation: Department of Urology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.
authors.forename: Johan A
authors.initials: JA
authors.lastname: van der Zee
authors.affiliation: Bristol Urological Institute, Bristol, UK.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ismail
authors.affiliation: Department of Urology, Darent Vally Hospital, Dartford, UK.
authors.forename: Khaled
authors.initials: K
authors.lastname: Farrag
authors.affiliation: Department of Urology, Frimley Park Hospital, Camberley, UK.|Department of Urology, Ain Shams University, Cairo, Egypt.
authors.forename: Amr M
authors.initials: AM
authors.lastname: Emara
authors.affiliation: Department of Urology, Odense University Hospital, Odense, Denmark.|Department of Urology, Viborg Regional Hospital, Viborg, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Lund
authors.affiliation: Department of Urology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Øyvind
authors.initials: Ø
authors.lastname: Østraat
authors.affiliation: Department of Urology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Michael
authors.initials: M
authors.lastname: Borre
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D003452:Cryosurgery; D005060:Europe; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: #KidneyCancer; #kcsm; complications; cryosurgery; laparoscopy; oncology; renal cell carcinoma; renal cryoablation