Short-Term and Long-Term Changes in Renal Function Following Percutaneous Cryoablation: A Comparison of Endophytic...

To determine the impact of endophytic vs exophytic tumor location on renal function following cryoablation.

A retrospective review of 450 procedures in 392 patients who underwent percutaneous cryoablation of renal tumors over a 10-year period was performed. Two propensity score-matched cohorts of patients with endophytic and exophytic tumors were identified. Primary outcomes were change in estimated glomerular filtration rate (eGFR) at 3 months, 6 months, 1 year, and 3 years, and progression of chronic kidney disease (CKD) to or beyond Stage 3.

After propensity score matching, each cohort consisted of 89 patients who underwent technically successful procedures. At 3 months, eGFR declined by 7.1 mL/min/1.73 m² from baseline in the endophytic group (P = .003), compared with 2.4 mL/min/1.73 m² (P = .68) in the exophytic group. By 3 years, patients with endophytic and exophytic tumors demonstrated a comparable decline (7.7 and 5.9 mL/min/1.73 m², respectively; P = .49). A greater proportion of patients with endophytic tumors progressed to CKD Stage 3b or higher at 1 year compared with those with exophytic tumors (10/76 vs 1/71; P = .01). At 3 years, there was no significant difference in proportion of patients who progressed to CKD Stage 3b or higher (7/65 vs 6/68, endophytic vs exophytic, respectively; P = .78).

Percutaneous cryoablation of endophytic tumors is associated with early eGFR CKD stage progression, although the long-term impact on renal function is comparable with that of exophytic tumors.