Table 1
Patient characteristics.
| PATIENT CHARACTERISTICS | N | % |
|---|---|---|
| Age | ||
| Mean ± standard deviation | 69 ± 10 | |
| Range | 45–88 | |
| Sex | ||
| Male | 51 | 69.5 |
| Female | 18 | 30.5 |
| Comorbidities | ||
| Smoking or history of smoking | 33 | 55.9 |
| Arterial hypertension | 43 | 72.9 |
| Diabetes type I or II | 15 | 25.4 |
| Chronic obstructive pulmonary disease | 7 | 11.9 |
| Chronic kidney disease (CKD) | 32 | 54.2 |
| CKD stage | ||
| 1 | 1 | 1.7 |
| 2 | 3 | 5.1 |
| 3 | 21 | 35.6 |
| 4 | 8 | 13.6 |
| 5 | 0 | 0 |
| Anticoagulant | 30 | 50.8 |
| Solitary kidney | 10 | 16.9 |
| Partial nephrectomy | 20 | 33.9 |
| Radical nephrectomy | 8 | 13.6 |
| Horseshoe kidney | 1 | 1.7 |
| Solitary kidney at birth | 1 | 1.7 |
| Polycystic kidneys | 1 | 1.7 |
| Von Hippel–Lindau | 1 | 1.7 |
Table 2
Tumor characteristics.
| TUMOR CHARACTERISTICS | N | % |
|---|---|---|
| Size (mm) | ||
| Mean ± SD | 23.7 ± 9.9 | |
| Range | 7–45 | |
| Laterality | ||
| R | 37 | 51.4 |
| L | 35 | 48.6 |
| Histology | 72 | |
| Clear cell RCC | 23 | 31.9 |
| Papillary RCC | 8 | 11.1 |
| Chromophile RCC | 1 | 1.4 |
| Chromophobe RCC | 2 | 2.8 |
| RCC with fibromatous stroma/RCC with leiomyomatous stroma | 1 | 1.4 |
| No biopsy of insufficient sample | 37 | 51.4 |
[i] R: right.
[ii] L: left.
[iii] RCC: renal cell carcinoma.
[iv] SD: standard deviation.
Figure 1
a. Non‑contrast axial CT scan before the cryoablation shows the exophytic RCC (thin white arrow) in the left kidney (K) and a big renal cyst (C). b. The cryoablation needle is inserted into the RCC through a posterolateral access route. c. Cryoablation needle in the RCC with a surrounding ice ball (thick white arrow). d. Non‑contrast axial CT scan after the procedure shows the ablated RCC (yellow arrow). e. Sagittal reconstruction CT scan shows the ablated RCC (A). f. Coronal reconstruction CT scan shows the ablated tumor (yellow arrow).
Figure 2
a. Contrast‑enhanced T1‑weighted MR‑image shows a hypovascular mass lesion (arrows) in the right anterior lower pole. b. Unenhanced, reconstructed parasagittal CT‑image during percutaneous cryoablation procedure shows exophytic mass lesion (arrows) and four needles within the mass lesion. c. Procedural retroperitoneal hemorrhage occurred and subsequent emergent selective angiography revealed two bleeding points (arrows) at the lower pole of the right kidney. d. Selective angiography after coil‑embolization (arrowheads) shows complete occlusion of the bleeding renal end branches.
Figure 3
Axial contrast‑enhanced CTs of the patient with two local tumor recurrences. a. RCC lesion in the left lower pole before ablation (white arrows). b. CT scan 3‑month post‑ablation shows no contrast enhancement in the ablation zone (white arrow). c. CT scan 12 months post‑ablation shows contrast enhancement (yellow arrow) in the ablation zone, and thus a local tumor recurrence. d. CT 3 months after the second cryoablation shows no residual tumor in the ablation zone (white arrow). e–f. On the CT 12 (e) and 18 months (f) post‑ablation the contrast enhancement was very subtle (yellow arrow) and stable. Patient is further followed‑up.
Figure 4
Kaplan–Meier estimate of local progression‑free survival is 87.4% (standard error of 4.8%) at 1 year.
Figure 5
Kaplan–Meier estimate of the OS rates at 1 year was 95.9% (standard error [SE] of 2.8%) and 91.6% (SE: 5.0%) at 3 years.