Safety and oncologic efficacy of percutaneous MRI-guided cryoablation of intraparenchymal renal cancers

Pierre De Marini; Roberto Luigi Cazzato; Julien Garnon; Danoob Dalili; Ian Leonard-Lorant; Loïc Leclerc; Pierre-Alexis Autrusseau; Pierre Auloge; Julia Weiss; Thibault Tricard; Hervé Lang; Afshin Gangi

doi:10.1016/j.diii.2021.04.002

Safety and oncologic efficacy of percutaneous MRI-guided cryoablation of intraparenchymal renal cancers

Diagn Interv Imaging. 2021 Sep;102(9):531-538. doi: 10.1016/j.diii.2021.04.002. Epub 2021 Apr 27.

Affiliations

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.

PMID: 33931365
DOI: 10.1016/j.diii.2021.04.002

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.

Keywords: Cryoablation; Interventional radiology; Kidney; Magnetic resonance imaging; Neoplasms.

MeSH terms

Adult
Aged
Aged, 80 and over
Carcinoma, Renal Cell* / diagnostic imaging
Carcinoma, Renal Cell* / surgery
Cryosurgery*
Female
Humans
Kidney Neoplasms* / diagnostic imaging
Kidney Neoplasms* / surgery
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Recurrence, Local
Retrospective Studies
Treatment Outcome