Laparoscopic cryoablation for clinical stage T1 renal masses: long-term oncologic outcomes at the Medical College of Wisconsin

Urology. 2014 Sep;84(3):613-8. doi: 10.1016/j.urology.2014.03.055.

Abstract

Objective: To report the long-term oncologic outcomes of laparoscopic cryoablation for clinical stage T1 renal masses at the Medical College of Wisconsin.

Materials and methods: A retrospective chart review was performed evaluating patients who underwent laparoscopic cryoablation for renal masses at the Medical College of Wisconsin between February 2000 and October 2009.

Results: A total of 171 renal masses in 144 patients were treated by laparoscopic cryoablation during the study period. After excluding patients with <5 years follow-up and those with >clinical stage I disease, 112 renal masses treated in 92 patients remained for analysis. Mean patient age was 59.6 years (standard deviation [SD], 12.5 years). Mean lesion size was 2.3 cm (SD, 0.94 cm). Mean age adjusted Charlson comorbidity index was 4.55 (SD, 1.69). Mean follow-up was 97.9 months (SD, 24.8 months). Overall survival among all patients was 80.9%. Lesions were biopsy proven to be malignant in 70 patients (76.3%). Of those with biopsy-proven malignancy, there were 6 recurrences, 14 non-cancer-related deaths, and 1 cancer-related death, leading to an overall survival of 77.6%, progression-free survival of 91.0%, and cancer-specific survival of 98.5%.

Conclusion: We report the largest published series of laparoscopic renal cryoablation with the longest follow-up. Our series indicates that laparoscopic cryoablation is both an efficacious treatment for clinical stage T1 renal masses and provides excellent long-term oncologic outcomes.

MeSH terms

  • Aged
  • Biopsy
  • Carcinoma, Renal Cell / mortality
  • Carcinoma, Renal Cell / surgery*
  • Cryosurgery / methods*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Neoplasms / mortality
  • Kidney Neoplasms / surgery*
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / surgery
  • Retrospective Studies
  • Robotics
  • Time Factors
  • Treatment Outcome