Pierre De Marini1, Roberto Luigi Cazzato2, Julien Garnon2, Danoob Dalili3, Ian Leonard-Lorant2, Loïc Leclerc2, Pierre-Alexis Autrusseau2, Pierre Auloge2, Julia Weiss2, Thibault Tricard4, Hervé Lang4, Afshin Gangi5. 1. Department of Interventional Radiology, University Hospital of Strasbourg, 67091 Strasbourg cedex, France. Electronic address: pierre.demarini@chru-strasbourg.fr. 2. Department of Interventional Radiology, University Hospital of Strasbourg, 67091 Strasbourg cedex, France. 3. School of Biomedical Engineering and Imaging Sciences, King's College London, Strand, WC2R 2LS London, United Kingdom. 4. Department of Urology, University Hospital of Strasbourg, 67091 Strasbourg cedex, France. 5. Department of Interventional Radiology, University Hospital of Strasbourg, 67091 Strasbourg cedex, France; School of Biomedical Engineering and Imaging Sciences, King's College London, Strand, WC2R 2LS London, United Kingdom.
Abstract
PURPOSE: The purpose of this study was to evaluate the safety and oncologic efficacy of percutaneous magnetic resonance imaging (MRI)-guided cryoablation of intraparenchymal renal cancer. MATERIALS AND METHODS: Between February 2009 and August 2019, 31 consecutives patients with 31 entirely intraparenchymal biopsy-proven renal cancers were treated with cryoablation under MRI-guidance in our institution, and were retrospectively included. There were 20 men and 11 women with a mean age of 68.5±12.5 (SD) (range: 40-91years). Patient, tumor- and procedure-related, and follow-up data were retrospectively collected and analyzed. Local recurrence free (LRFS), metastasis free (MFS), disease free (DFS), cancer specific (CSS), and overall survivals (OS) were calculated. RESULTS: Primary and secondary technical efficacy rates were 94% and 100%, respectively. Median follow-up was 27months. Seven (7/31; 23%) minor complications were noted in 7 patients. Patients showed a significant decline of the estimated glomerular filtration rate (eGFR) between baseline and nadir (mean basal eGFR 65.9±22.4 [SD] mL/min/1.73m2vs. mean nadir eGFR 52.8±26.0 [SD] mL/min/1.73m2; P<0.001), but only two showed a clinically significant renal function decline. Three-year estimates of primary and secondary LRFS, MFS, and DFS were 64% (95% confidence interval [CI]: 47-87%), 89% (95% CI: 78-99%), 83% (95% CI: 77-98%), and 45% (95% CI: 28-73%), respectively. No patients died due to renal cancer evolution (three-year CSS of 100%; 95% CI: 100-100%). One patient died 52months after the percutaneous treatment due to cryoablation-unrelated causes (three-year OS of 100%; 95% CI: 100-100%). CONCLUSION: MRI-guided percutaneous cryoablation for intraparenchymal renal cancer offers good oncologic outcomes with acceptable complication rates and renal function worsening.
PURPOSE: The purpose of this study was to evaluate the safety and oncologic efficacy of percutaneous magnetic resonance imaging (MRI)-guided cryoablation of intraparenchymal renal cancer. MATERIALS AND METHODS: Between February 2009 and August 2019, 31 consecutives patients with 31 entirely intraparenchymal biopsy-proven renal cancers were treated with cryoablation under MRI-guidance in our institution, and were retrospectively included. There were 20 men and 11 women with a mean age of 68.5±12.5 (SD) (range: 40-91years). Patient, tumor- and procedure-related, and follow-up data were retrospectively collected and analyzed. Local recurrence free (LRFS), metastasis free (MFS), disease free (DFS), cancer specific (CSS), and overall survivals (OS) were calculated. RESULTS: Primary and secondary technical efficacy rates were 94% and 100%, respectively. Median follow-up was 27months. Seven (7/31; 23%) minor complications were noted in 7 patients. Patients showed a significant decline of the estimated glomerular filtration rate (eGFR) between baseline and nadir (mean basal eGFR 65.9±22.4 [SD] mL/min/1.73m2vs. mean nadir eGFR 52.8±26.0 [SD] mL/min/1.73m2; P<0.001), but only two showed a clinically significant renal function decline. Three-year estimates of primary and secondary LRFS, MFS, and DFS were 64% (95% confidence interval [CI]: 47-87%), 89% (95% CI: 78-99%), 83% (95% CI: 77-98%), and 45% (95% CI: 28-73%), respectively. No patientsdied due to renal cancer evolution (three-year CSS of 100%; 95% CI: 100-100%). One patientdied 52months after the percutaneous treatment due to cryoablation-unrelated causes (three-year OS of 100%; 95% CI: 100-100%). CONCLUSION: MRI-guided percutaneous cryoablation for intraparenchymal renal cancer offers good oncologic outcomes with acceptable complication rates and renal function worsening.