Preoperative lipiodol marking and its role on survival and complication rates of CT-guided cryoablation for small renal masses
2017
Partial nephrectomy for small renal masses (SRM) may be useful for preserving renal function, but is technically more difficult than radical nephrectomy.
Cryoablationmay be performed under
local anesthesia. The objective of the present study is to assess the safety and therapeutic efficacy of
cryoablationwith
lipiodolmarking for SRM.
Cryoablationtherapy was performed on 42 patients under
local anesthesia. Their median age was 74 years (31–91). The median tumor diameter was 21 mm (10–42). Responses to the treatment were evaluated using modified
Response Evaluation Criteriain
Solid Tumors(mRECIST) by contrast-enhanced CT. In six patients (14.3%) for whom it was not possible to use contrast medium, plain CT findings were assessed according to
Response Evaluation Criteriain
Solid Tumors(RECIST). Twenty-nine (69%) and five (12%) patients achieved complete responses (CR) and partial responses (PR), respectively, while four (10%) and four (10%) patients each had stable disease (SD) and progressive disease (PD) after the first course of therapy. A second course of
cryoablationtherapy with
lipiodolmarking was performed on three out of four patients with PD after the first course of therapy, and resulted in a total of 32 patients achieving CR (76%). Four (36.4%) out of 11 patients for whom
lipiodolmarking was not conducted had PD, whereas none of the 31 patients for whom
lipiodolmarking was conducted had PD. All grade complications were reported in 11 (24.4%) patients while grade 3 in two (4.4%) patients. 11 (24.4%) A significant difference was observed in postoperative hemorrhagic events in all grades (18% in patients undergoing
cryoablationwithout
lipiodolmarking vs. 0% in patients undergoing
cryoablationwithout
lipiodolmarking). Although further studies involving more patients are needed in order to evaluate long-term results,
cryoablationtherapy appears to be a useful treatment option for SRM. Preoperative marking with
lipiodolwas helpful for improving complication and survival rates with
cryoablation.
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