‘Freezing' Kidney Tumors is Effective and Less Costly than Laparoscopic Surgery

The comparative trial shows that percutaneous cryoablation results in a slightly lower recurrence rate of the tumor, a shorter hospital stay, no major complications, and a 59.5% lower hospital cost than the laparoscopic treatment. During cryoablation, argon gas enters the tip of the probe and extracts heat from the surrounding cells, resulting in an "ice ball” that freezes and kills the tumor. The nonsurgical treatment spares most of the healthy kidney tissue and can be repeated as frequently as required. This interventional treatment had no major complications as opposed to the surgical group, which experienced complications in 6% of those evaluated.

In the procedure, the radiologist uses imaging to pinpoint the tumor, and then inserts the cryoprobe through the skin, similar to the way a biopsy is performed. This can be performed under general anesthesia, but is frequently possible with only local anesthesia and conscious sedation. By utilizing imaging, the radiologist can avoid going through any adjacent structures or harming healthy tissue. If necessary, adjacent structures can be displaced prior to the ablation to minimize collateral damage. Laparoscopy, conversely, requires general anesthesia, as well as multiple abdominal incisions to allow access for the surgical instruments. It is also associated with a longer recovery time.

"This early stage research indicates that percutaneous cryoablation in the appropriate patient population can effectively kill tumors, while also offering patients a shorter hospital stay, a faster recovery, and an excellent safety profile, all at a lower cost than laparoscopy,” noted study investigator J. Louis Hinshaw, M.D., from the University of Wisconsin-Madison (USA).

The research was presented on March 2, 2007, at the Society of Interventional Radiology's 32nd annual scientific meeting held in Seattle, WA, USA. The U.S. Food and Drug Administration (FDA) has approved both radiofrequency ablation and cryoablation for use in soft tissue tumors, of which renal cell carcinoma is one.

The study's findings included: laparoscopic cryoablation had a slightly higher tumor recurrence rate (12.5 vs 10.5%); percutaneous cryoablation required fewer days in the hospital (1.1 vs 2.5); percutaneous cryoablation had no major complications (0 vs 6.3%); and percutaneous cryoablation cost 59.5% less than the laparoscopic approach.

Surgical removal of tumors confined to the kidney provides the best chance for a cure. Unfortunately, some patients may not tolerate surgery because of underlying medical conditions, and some patients, particularly those with small tumors, may not want to have surgery for their cancer. In this group of patients, minimally invasive image-guided therapies offer a less invasive alternative. These interventional treatments can also provide valuable benefits to some patients with advanced or metastatic renal cell carcinoma.


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