Safety and Technical Feasibility of Percutaneous Renal Cryoablation of Central Tumors without Pyeloperfusion

To assess the safety and technical success of percutaneous cryoablation (PCA) without pyeloperfusion in 94 patients with central renal tumors.

A retrospective review of all central renal tumors treated by PCA without pyeloperfusion was performed. Central tumors were defined as those involving the renal sinus fat on preprocedural cross-sectional imaging. Patient demographics and baseline tumor characteristics were recorded. The details of the PCA procedure, primary and secondary technical success, rates of local recurrence, adverse events (AEs), cancer-specific survival (CSS), and overall survival (OS) were compiled.

Ninety-four patients (48 females [51%]; mean age, 68.2 years [range, 38-87 years]) with 94 central renal tumors were included. The mean maximal tumor diameter and mean RENAL nephrometry score were 37 mm (range, 15-67 mm) and 8 (range, 4-11), respectively. Primary technical success was achieved in 94% (n = 88) of procedures. Of the patients who did not achieve primary technical success, 3 underwent successful repeat PCA (secondary technical success, 97%; n = 91/94). The other 3 patients were surveilled for residual disease. Twenty-four patients (26%) required hydrodissection during PCA. Six patients (6%) experienced major AEs after PCA including hemorrhage requiring embolization (n = 3), hemorrhage requiring transfusions with admission (n = 2), and perinephric abscess necessitating drain placement (n = 1). Twenty-two patients (23%) experienced minor AEs. Nine patients (10%) experienced local recurrence during the follow-up period. OS was 94% (n = 88/94), whereas CSS was 98% (n = 92/94) during the study follow-up period (mean, 16 months [range, 1-102 months]).

PCA of central renal tumors appears to be safe with high rates of technical success, even without the use of pyeloperfusion.