Laparoscopic Renal Cryoablation

8-Year, Single Surgeon Outcomes

Monish Aron, Kazumi Kamoi, Erick Remer, Andre Berger, Mihir Desai, Inderbir Gill

Research output: Contribution to journalArticle

112 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)889-895
Number of pages7
JournalJournal of Urology
Volume183
Issue number3
DOIs
StatePublished - Mar 2010
Externally publishedYes

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Cryosurgery
Kidney
Disease-Free Survival
Nephrectomy
Renal Cell Carcinoma
Recurrence
Survival Rate
Neoplasm Metastasis
Biopsy
Surgeons
Neoplasms
Body Mass Index
Multivariate Analysis
Magnetic Resonance Imaging

Keywords

  • cryosurgery
  • kidney
  • kidney neoplasms
  • laparoscopy
  • outcome assessment (health care)

ASJC Scopus subject areas

  • Urology

Cite this

Aron, M., Kamoi, K., Remer, E., Berger, A., Desai, M., & Gill, I. (2010). Laparoscopic Renal Cryoablation: 8-Year, Single Surgeon Outcomes. Journal of Urology, 183(3), 889-895. https://doi.org/10.1016/j.juro.2009.11.041

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 journalArticle

Aron, M, Kamoi, K, Remer, E, Berger, A, Desai, M & Gill, I 2010, 'Laparoscopic Renal Cryoablation: 8-Year, Single Surgeon Outcomes', Journal of Urology, vol. 183, no. 3, pp. 889-895. https://doi.org/10.1016/j.juro.2009.11.041
Aron, Monish ; Kamoi, Kazumi ; Remer, Erick ; Berger, Andre ; Desai, Mihir ; Gill, Inderbir. / Laparoscopic Renal Cryoablation : 8-Year, Single Surgeon Outcomes. In: Journal of Urology. 2010 ; Vol. 183, No. 3. pp. 889-895.
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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.",
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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.

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