Safety and oncologic efficacy of percutaneous MRI-guided cryoablation of intraparenchymal renal cancers

Purpose: The purpose of this study was to evaluate the safety and oncologic efficacy of percutaneous magnetic resonance imaging (MRI)-guided cryoablation of intraparenchymal renal cancer. Materials and methods: Between February 2009 and August 2019, 31 consecutives patients with 31 entirely intraparenchymal biopsy-proven renal cancers were treated with cryoablation under MRI-guidance in our institution, and were retrospectively included. There were 20 men and 11 women with a mean age of 68.5 +/- 12.5 (SD) (range: 40- 91 years). Patient, tumor- and procedure-related, and follow-up data were retrospectively collected and analyzed. Local recurrence free (LRFS), metastasis free (MFS), disease free (DFS), cancer specific (CSS), and overall survivals (OS) were calculated. Results: Primary and secondary technical efficacy rates were 94% and 100%, respectively. Median followup was 27 months. Seven (7/31; 23%) minor complications were noted in 7 patients. Patients showed a significant decline of the estimated glomerular filtration rate (eGFR) between baseline and nadir (mean basal eGFR 65.9 +/- 22.4 [ SD] mL/min/1.73 m(2) vs. mean nadir eGFR 52.8 +/- 26.0 [ SD] mL/min/1.73 m(2) ; P< 0.001), but only two showed a clinically significant renal function decline. Three-year estimates of primary and secondary LRFS, MFS, and DFS were 64% (95% confidence interval [CI]: 47- 87%), 89% (95% CI: 78- 99%), 83% (95% CI: 77- 98%), and 45% (95% CI: 28- 73%), respectively. No patients died due to renal cancer evolution (three-year CSS of 100%; 95% CI: 100- 100%). One patient died 52 months after the percutaneous treatment due to cryoablation-unrelated causes (three-year OS of 100%; 95% CI: 100-100%). Conclusion: MRI-guided percutaneous cryoablation for intraparenchymal renal cancer offers good oncologic outcomes with acceptable complication rates and renal function worsening. (C) 2021 Societe francaise de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Automated summary

The study evaluated the safety and oncologic efficacy of percutaneous MRI-guided cryoablation for intraparenchymal renal cancer. Results showed good oncologic outcomes with acceptable complication rates and renal function worsening.