Cryoablation for Secondary Renal Cell Carcinoma After Surgical Nephrectomy
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CLINICAL INVESTIGATION
INTERVENTIONAL ONCOLOGY
Cryoablation for Secondary Renal Cell Carcinoma After Surgical Nephrectomy Yasuhiro Ushijima1 • Yoshiki Asayama1,2 • Akihiro Nishie1 • Yukihisa Takayama1 Yuichiro Kubo1 • Keisuke Ishimatsu1 • Kousei Ishigami1
•
Received: 6 July 2020 / Accepted: 2 November 2020 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020
Abstract Purpose To retrospectively evaluate the clinical outcomes of cryoablation for secondary renal cell carcinoma for patients with a history of nephrectomy for initial renal cell carcinoma. Materials and Methods Thirty patients with 40 renal tumors who had undergone a nephrectomy for initial renal cell carcinoma and cryoablation for renal cell carcinoma as a secondary treatment during the period from April 2014 to December 2018 at a single center institution were enrolled. The patients’ overall survival, local control, relapse-free survival, change of renal function, and complications were evaluated. The clinical factors of relapse-free survival were also evaluated. Results The 5 year overall survival rate was 94.5%, the 5 year local control rate was 89.3%, and the 5 year relapsefree survival rate (RFSR) was 56.3%. There was an average reduction in renal function of 8.5% after 1 year, and [ grade 3 complications occurred in only one case. The RFSR in the patients whose initial stage was T3 was 0%, significantly lower than the 70.4% RFSR in the patients whose initial stage was T1 or T2. Conclusion Cryoablation for secondary renal cell carcinoma after nephrectomy was safe and provided good local control with preserved renal function. However, the
& Yasuhiro Ushijima [email protected] 1
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
2
Present Address: Faculty of Medicine, Department of Radiology, Oita University, Oita, Japan
indications for cryoablation should be carefully considered for patients with T3-stage initial renal cell carcinoma, because of the high risk of relapse. Level of evidence III Keywords Cryoablation Renal cell carcinoma Nephrectomy Metastatic Multicentric
Introduction The treatment options for small-sized renal cell carcinoma are surgical nephrectomy, ablation (cryoablation and radiofrequency ablation), and active surveillance. Surgical nephrectomy including total and partial nephrectomy is now recognized as the standard treatment worldwide [1]. Robot-assisted nephrectomy has also recently been performed [2]. Cryoablation is a new treatment for small-sized renal cell carcinoma following surgical nephrectomy. Although there have been fewer case reports and less evidence regarding ablation for renal cell carcinoma compared to surgical nephrectomy, several studies have reported that cryoablation for renal cell carcinoma achieved a high local control rate equivalent to that of surgical nephrectomy, and that cryoablation
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