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

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Pierre De Marini, Roberto Luigi Cazzato, Julien Garnon, Danoob Dalili, Ian Leonard-Lorant, Loïc Leclerc, Pierre Alexis Autrusseau, Pierre Auloge, Julia Weiss, Thibault Tricard, Hervé Lang, Afshin Gangi

Original languageEnglish
Pages (from-to)531-538
Number of pages8
JournalDiagnostic and interventional imaging
Volume102
Issue number9
DOIs
PublishedSep 2021

Bibliographical note

Publisher Copyright: © 2021 Société française de radiologie Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

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Abstract

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 follow-up 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 m2 vs. mean nadir eGFR 52.8 ± 26.0 [SD] mL/min/1.73 m2; 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.

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