Work

Preliminary Assessment of Cone Beam CT Guided Percutaneous Cryoablation for CT1A Renal Cell Carcinoma: A Relatively Novel and Underutilized Technique

Year: 2025

Type: article

Abstract: To assess the efficacy and safety of cone beam CT guided percutaneous cryoablation (CBCT guided PCA) for the treatment of cT1a renal tumours by evaluating oncological outcomes and postoperative complication risk, in comparison to conventional CT guided PCA and laparoscopic cryoablation (LCA) using long-term follow-up data from a single-center cohort. A retrospective analysis of three cryoablation (CA) techniques was conducted at our institution from December 2006 to February 2023. A total of 77 (32.6%) patients underwent CBCT guided PCA, 34 (14.4%) received CT guided PCA, and 125 (53%) were treated with LCA. Primary outcomes included recurrence-free survival (RFS) and overall complication rate (OCR). RFS was calculated using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards analyses assessed the impact of specific baseline characteristics on recurrence risk. 19 (8.1%) patients exhibited local disease recurrence during follow-up. Recurrence occurred in seven (9.1%), four (11.8%), and eight (6.4%) patients in the CBCT guided PCA, CT guided PCA, and LCA group, respectively ( p = 0.549). The overall RFS was 90.1%, 88.2%, and 93.6% for CBCT guided PCA, CT guided PCA, and LCA, respectively. RFS did not differ significantly between the three groups (Log-rank for trend: p = 0.083). No significant difference in overall recurrence (OCR) was observed among the groups ( p = 0.200). CBCT guided PCA shows higher overall RFS in comparison to CT guided PCA and thereby is an effective and safe alternative for the treatment of small renal masses. A comparative analysis was conducted among Cone Beam CT guided (CBCT) percutaneous cryoablation (PCA), conventional CT guided PCA, and laparoscopic cryoablation (LCA) for the treatment of cT1a renal tumours. In this retrospective study involving 236 patients, CBCT guided PCA exhibited a superior overall RFS when compared to conventional CT guided PCA. Overall RFS did not differ significantly between the three groups. No statistically significant differences were observed in the overall complication rate (OCR) across the three treatment modalities. The RENAL score was identified as a significant predictor of disease recurrence. Further investigation and validation through additional studies are recommended.

Source: Clinical Genitourinary Cancer

DOI: 10.1016/j.clgc.2025.102329

Authors: M. Duijn, A.E.C. Ruiter, A.D. Montauban van Swijndregt, V.P.M. van der Hulst, B.W. Lagerveld

Institutions: OLVG, Amsterdam University Medical Centers, University of Amsterdam

Language: English

Topic: Renal cell carcinoma treatment

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,530