Abstract
Purpose: We present 5 to 11-year (median 8) oncological outcomes after laparoscopic renal cryoablation. Materials and Methods: Between September 1997 and October 2008 we performed renal cryoablation in 340 patients, of whom 80 treated laparoscopically by a single surgeon before October 2003 had a minimum 5-year followup. Followup involved magnetic resonance imaging on postoperative day 1, at 3, 6 and 12 months, and annually thereafter. Cryolesion biopsy was performed at 6 months. All data were prospectively accrued. Results: In the 80 patients with minimum 5-year followup mean age was 66 years, mean tumor size was 2.3 cm (range 0.9 to 5.0), median American Society of Anesthesiologists score was 3 and mean body mass index was 28 kg/m2. Five patients had local recurrence, 2 had locoregional recurrence with metastasis and 4 had distant metastasis without locoregional recurrence. Six patients died of cancer. In the 55 patients with biopsy proven renal cell cancer at a median followup of 93 months (range 60 to 132) 5-year overall, disease specific and disease-free survival rates were 84%, 92% and 81%, and 10-year rates were 51%, 83% and 78%, respectively. On multivariate analysis previous radical nephrectomy for RCC was the only significant predictor of disease-free and disease specific survival (p = 0.023 and 0.030, respectively). Conclusions: Laparoscopic renal cryoablation is effective oncological treatment for a renal mass in select patients. A disease specific survival rate of 92% at 5 years and 83% at 10 years is possible. Preceding radical nephrectomy for renal cell carcinoma was the only independent factor predicting disease-free and disease specific survival.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 889-895 |
| Number of pages | 7 |
| Journal | Journal of Urology |
| Volume | 183 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 2010 |
| Externally published | Yes |
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Keywords
- cryosurgery
- kidney
- kidney neoplasms
- laparoscopy
- outcome assessment (health care)
ASJC Scopus subject areas
- Urology
Cite this
Laparoscopic Renal Cryoablation : 8-Year, Single Surgeon Outcomes. / Aron, Monish; Kamoi, Kazumi; Remer, Erick; Berger, Andre; Desai, Mihir; Gill, Inderbir.
In: Journal of Urology, Vol. 183, No. 3, 03.2010, p. 889-895.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Laparoscopic Renal Cryoablation
T2 - 8-Year, Single Surgeon Outcomes
AU - Aron, Monish
AU - Kamoi, Kazumi
AU - Remer, Erick
AU - Berger, Andre
AU - Desai, Mihir
AU - Gill, Inderbir
PY - 2010/3
Y1 - 2010/3
N2 - Purpose: We present 5 to 11-year (median 8) oncological outcomes after laparoscopic renal cryoablation. Materials and Methods: Between September 1997 and October 2008 we performed renal cryoablation in 340 patients, of whom 80 treated laparoscopically by a single surgeon before October 2003 had a minimum 5-year followup. Followup involved magnetic resonance imaging on postoperative day 1, at 3, 6 and 12 months, and annually thereafter. Cryolesion biopsy was performed at 6 months. All data were prospectively accrued. Results: In the 80 patients with minimum 5-year followup mean age was 66 years, mean tumor size was 2.3 cm (range 0.9 to 5.0), median American Society of Anesthesiologists score was 3 and mean body mass index was 28 kg/m2. Five patients had local recurrence, 2 had locoregional recurrence with metastasis and 4 had distant metastasis without locoregional recurrence. Six patients died of cancer. In the 55 patients with biopsy proven renal cell cancer at a median followup of 93 months (range 60 to 132) 5-year overall, disease specific and disease-free survival rates were 84%, 92% and 81%, and 10-year rates were 51%, 83% and 78%, respectively. On multivariate analysis previous radical nephrectomy for RCC was the only significant predictor of disease-free and disease specific survival (p = 0.023 and 0.030, respectively). Conclusions: Laparoscopic renal cryoablation is effective oncological treatment for a renal mass in select patients. A disease specific survival rate of 92% at 5 years and 83% at 10 years is possible. Preceding radical nephrectomy for renal cell carcinoma was the only independent factor predicting disease-free and disease specific survival.
AB - Purpose: We present 5 to 11-year (median 8) oncological outcomes after laparoscopic renal cryoablation. Materials and Methods: Between September 1997 and October 2008 we performed renal cryoablation in 340 patients, of whom 80 treated laparoscopically by a single surgeon before October 2003 had a minimum 5-year followup. Followup involved magnetic resonance imaging on postoperative day 1, at 3, 6 and 12 months, and annually thereafter. Cryolesion biopsy was performed at 6 months. All data were prospectively accrued. Results: In the 80 patients with minimum 5-year followup mean age was 66 years, mean tumor size was 2.3 cm (range 0.9 to 5.0), median American Society of Anesthesiologists score was 3 and mean body mass index was 28 kg/m2. Five patients had local recurrence, 2 had locoregional recurrence with metastasis and 4 had distant metastasis without locoregional recurrence. Six patients died of cancer. In the 55 patients with biopsy proven renal cell cancer at a median followup of 93 months (range 60 to 132) 5-year overall, disease specific and disease-free survival rates were 84%, 92% and 81%, and 10-year rates were 51%, 83% and 78%, respectively. On multivariate analysis previous radical nephrectomy for RCC was the only significant predictor of disease-free and disease specific survival (p = 0.023 and 0.030, respectively). Conclusions: Laparoscopic renal cryoablation is effective oncological treatment for a renal mass in select patients. A disease specific survival rate of 92% at 5 years and 83% at 10 years is possible. Preceding radical nephrectomy for renal cell carcinoma was the only independent factor predicting disease-free and disease specific survival.
KW - cryosurgery
KW - kidney
KW - kidney neoplasms
KW - laparoscopy
KW - outcome assessment (health care)
UR - http://www.scopus.com/inward/record.url?scp=76049108554&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=76049108554&partnerID=8YFLogxK
U2 - 10.1016/j.juro.2009.11.041
DO - 10.1016/j.juro.2009.11.041
M3 - Article
VL - 183
SP - 889
EP - 895
JO - Journal of Urology
JF - Journal of Urology
SN - 0022-5347
IS - 3
ER -