Summary
The aim of energy-based tissue ablative procedures for renal cell carcinoma is to achieve complete destruction of the cancer cells, targeting the entire visualized tumor with a surrounding margin of healthy renal parenchyma. Based on recent technological advances of cryodelivery systems and imaging technology, cryoablation has now been performed via open, laparoscopic, and percutaneous approaches worldwide. Because immediate pathological confirmation of complete cancer cell death with negative surgical margin is impossible in cryoablation of renal tumor, clinical long-term follow-up with meticulous imaging assessment and needle biopsy data is necessary to determine the oncological effi- cacy of cryoablation for renal cell carcinoma. Recently, the authors reported intermediate-term oncological follow-up data on 56 patients, of whom each completed a 3-year follow-up after laparoscopic renal cryoablation. Overall 3-year cancer-specific survival was 98%. The intermediate-term oncological data are encouraging for continued performance of renal cryoablation for renal cell carcinoma in carefully selected older patients with a small renal mass. Technically, the authors routinely attempt to extend the iceball at least 1 cm beyond the edge of the tumor to achieve the tumoricidal temperature within the entire extent of the tumor.
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References
Uzzo RG, Novick AC (2001) Nephron sparing surgery for renal tumors: indications, techniques and outcomes. J Urol 166:6–18
Gill IS, Novick AC, Sobble JJ, et al (1998) Laparoscopic renal cryoablation: initial clinical series. Urology 52:543–551
Gill IS, Desai MM, Kaouk JH, et al (2002) Laparoscopic partial nephrectomy for renal tumor: duplicating open surgical techniques. J Urol 167:469–477
Ukimura O, Kawauchi A, Fujito A, et al (2004) Radio-frequency ablation of renal cell carcinoma in patients who were at significant risk. Int J Urol 11:1051–1057
Gill IS (2003) Minimally invasive nephron-sparing surgery. Urol Clin N Am 30:551–579
Gage AA, Baust J (1998) Mechanisms of tissue injury in cryosurgery. Cryobiology 37:171–186
Campbell SC, Krishnamurthi V, Chow G, Hale J, Myles J, Novick AC (1998) Renal cryosurgery: experimental evaluation of treatment parameters. Urology 52:29–33
Woolley ML, Sclsinger DA, Durand DB, et al (2002) Effect of freezing parameters (freeze cycle and thaw process) on tissue destruction following renal cryoablation. J Endourol 16:519–522
Chosy SG, Nakada SY, Lee FT Jr, et al (1998) Monitoring renal cryosurgery: predictors of tissue necrosis in swine. J Urol 159:1370–1374
Sung GT, Gill IS, Hsu TH, et al (2003) Effect of intentional cryo-injury to the renal collecting system. J Urol 170:619–622
Uchida M, Imaide Y, Sugimoto K, et al (1995) Percutaneous cryosurgery for renal tumours. Br J Urol 75:132–136
Gill IS, Novick AC, Meraney AM, et al (2000) Laparoscopic renal cryoablation in 32 patients. Urology 56:748–753
Gill IS, Remer EM, Hasan WA, et al (2005) Renal cryoablation: outcome at 3 years. J Urol. 173:1903–1907
Remer EM, Weinberg EJ, Oto A, et al (2000) MR imaging of the kidneys after laparoscopic cryoablation. AJR Am J Roentgenol 174:635–640
Silverman SG, Tuncali K, vanSonnenberg E, et al (2005) Renal tumors: MR imagingguided percutaneous cryotherapy-initial experience in 23 patients. Radiology 236:716–724
Bassignari MJ, Moore Y, Watson L, et al (2004) Pilot experience with realtime ultrasound guided percutaneous renal mass cryoablation. J Urol 171:1620–1623
Gupta A, Allaf ME, Kavoussi LR, et al (2006) Computerized tomography guided percutaneous renal cryoablation with the patient under conscious sedation: initial clinical experience. J Urol 175:447–452
Delworth MG, Pisters LL, Fornage BD, von Eschenvach AC (1996) Cryotherapy for renal cell carcinoma and angiomyolipoma. J Urol155:252–254
Bishoff JT, Chen RB, Lee BR, et al (1999) Laparoscopic renal cryoablation: acute and long-term clinical, radiographic, and pathologic effects in an animal model and application in a clinical trial. J Endourol 13:233–239
Rodriguez R, Chan DY, Bishoff JT, et al (2000) Renal ablative cryosurgery in selected patients with peripheral renal masses. Urology 55:25–30
Rukstalis DB, Khorsandi M, Garcia FU, et al (2001) Clinical experience with open renal cryoablation. Urology 57:34–39
Shingleton WB, Sewell PE Jr (2001) Percutaneous renal tumor cryoablation with magnetic resonance imaging guidance. J Urol 165:773–776
Carvalhal EF, Gill IS, Meraney AM, et al (2001) Laparoscopic renal cryoablation: impact on renal function and blood pressure. Urology 258:357–361
Harada J, Dohi J, Mogami T, et al (2001) Initial experience of percutaneous renal cryosurgery under the guidance of a horizontal open MRI system. Radiat Med 19:291–296
Shingleton WB, Sewell PE Jr (2002) Percutaneous renal cryoablation of renal tumors in patients with von Hippel-Lindau disease. J Urol. 167:1268–1270
Lee DI, McGinnis De, Feld R, et al (2003) Retroperitoneal laparoscopic cryoablation of small renal tumors: intermediate results. Urology 61:83–88
Shingleton WB, Sewell PE Jr (2003) Cryoablation of renal tumours in patients with solitary kidneys. BJU Int 92:237–239
Nadler RB, Kim SC, Rubenstein JN, et al (2003) Laparoscopic renal cryosurgery: the Northwestern experience. J Urol 170:1121–1125
Moon TD, Lee FT Jr, Hedican SP, et al (2004) Laparoscopic cryoablation under sonographic guidance for the treatment of small renal tumors. J Endourol 18:436–440
Cestari A, Guazzoni G, Dell’Acqua V, et al (2004) Laparoscopic cryoablation of solid renal masses: intermediate term followup. J Urol 172:1267–1270
Tuncali K, vanSonnenberg E, Shankar S, et al (2004) Evaluation of patients referred for percutaneous ablation of renal tumors: importance of a preprocedural diagnosis. AJR Am J Roentgenol 183:575–582
Bachmann A, Sulser T, Jayet C, et al (2005) Retroperitoneoscopy-assisted cryoablation of renal tumors using multiple 1.5 mm ultrathin cryoprobes: a preliminary report. Eur Urol 47:474–479
Gore JL, Kim HL, Schulam P (2005) Initial experience with laparoscopically assisted percutaneous cryotherapy of renal tumors. J Endourol 19:480–483
Ukimura O, Kaouk J, Remer EM, et al (2006) Real-time virtual sonography guided percutaneous radiofrequency-ablation of renal tumor: initial experience. J Urol (Suppl) AUA (abstract) (in press)
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© 2006 The Japanese Society of Endourology and ESWL
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Ukimura, O., Gill, I.S. (2006). Cryoablation for Renal Cell Carcinoma. In: Baba, S., Ono, Y. (eds) Interventional Management of Urological Diseases. Recent Advances in Endourology, vol 8. Springer, Tokyo. https://doi.org/10.1007/978-4-431-35642-4_4
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DOI: https://doi.org/10.1007/978-4-431-35642-4_4
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