Long-term oncologic outcomes of laparoscopic renal cryoablation as primary treatment for small renal masses

Alessandro Larcher, Nicola Fossati, Francesco Mistretta, Giovanni Lughezzani, Giuliana Lista, Paolo Dell'Oglio, Alberto Abrate, Maxine Sun, Pierre Karakiewicz, Nazareno Suardi, Massimo Lazzeri, Francesco Montorsi, Giorgio Guazzoni, Nicolò Buffi

Research output: Contribution to journalArticle

Abstract

Introduction: Data regarding long-term oncologic outcomes of laparoscopic renal cryoablation (LRC) as first treatment for small renal masses (SRMs) are lacking. We hypothesized that LRC might provide an effective long-term cancer control in patients with a single cT1a SRM without a previous history of renal cell carcinoma (RCC). Materials and methods: The study design was a retrospective analysis of 174 consecutive patients who received LRC as first treatment for a single computed tomography or magnetic resonance imaging contrast-enhancing cT1a SRM between 2000 and 2013. Patients with a previous history of RCC were excluded. Treatment failure was evaluated 1 day after surgery. Local recurrence, metachronous SRM, systemic progression, disease relapse, cancer-specific mortality, and all-cause mortality were evaluated 10 years after surgery. Kaplan-Meier plots were used to depict outcome-free survival rate. Results: Median patient age was 66 years. Median tumor size was 20. mm. Median follow-up was 48 months. Among patients with biopsy-proven RCC (63%, n = 109), the treatment failure-free rate was 98%. The 10-year recurrence-free survival rate was 95% and the 10-year metachronous SRM-free survival rate was 87%. The 10-year systemic progression-free survival rate was 100% and the 10-year disease relapse-free survival rate was 81%. The cancer-specific mortality-free survival rate was 100%, and the all-cause mortality-free survival rate was 61%. Conclusions: LRC provides safe long-term cancer control in patients newly diagnosed with a single cT1a SRM. Treatment failure and local recurrence are uncommon. Systemic progression-free survival and cancer-specific-free survival are optimal.

Original languageEnglish
Pages (from-to)22.e1-22.e9
JournalUrologic Oncology: Seminars and Original Investigations
Volume33
Issue number1
DOIs
Publication statusPublished - Jan 1 2015

Keywords

  • Kidney cancer
  • Local tumor ablation
  • Long-term oncologic outcomes
  • Nephron-sparing surgery
  • Renal cryoablation
  • Small renal masses

ASJC Scopus subject areas

  • Oncology
  • Urology

Fingerprint Dive into the research topics of 'Long-term oncologic outcomes of laparoscopic renal cryoablation as primary treatment for small renal masses'. Together they form a unique fingerprint.

  • Cite this