Cryoablation of localized renal cancer on the MKS cryotherapy unit with liquid nitrogen as a cryogen: functional and oncological efficiency of the method

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Abstract

BACKGROUND: Ablation is a method of destroying a pathological focus using a controlled temperature or other effect. The most promising ablative treatment for localized kidney cancer today is cryoablation.

AIM: To analyze functional and oncological results of cryoablation of localized kidney cancer using liquid nitrogen as cryogen.

MATERIALS AND METHODS: Between 2017 and 2020, 56 patients with suspected localized kidney cancer were observed and treated at the N.N. Petrov National Medical Research Center of Oncology. With morphological verification, renal cell carcinoma was detected in 19 (65.5%) patients, chromophobe renal cell carcinoma – in 3 (10.4%), oncocytoma – in 3 (10.4%), in 4 (13.8%) cases the tumor was not detected in morphological material. All patients underwent cryoablation using the MKS cryotherapy unit with liquid nitrogen as a cryogen (ultrasound-guide cryotherapy was performed in 4 (7.1%) cases, CT-guide – in 46 (82.1%), laparoscopically – in 6 (10.7%) patients).

RESULTS: Renal function in this study was assessed by creatinine level and glomerular filtration rate (GFR) before and after cryoablation. The creatinine level before cryoablation was 101 ± 18 µmol/l, after – 113.8 ± 18 µmol/l (p = 0.21), GFR before cryoablation – 63 ± 13 ml/min, after – 65 ± 13 ml/min. These differences were not significant (p = 0.87). Local disease control was achieved in 100% of cases. The overall and specific survival rate were 100% (one patient died from synchronous primary multiple cancer at 4 years of observation), the survival rate to recurrence was 90.9 ± 3.9%, and the event-free survival was 70.2 ± 6.6%. During the follow-up period, 9 (16%) recurrences of the disease were diagnosed.

CONCLUSIONS: Cryoablation makes it possible to maintain a large volume of renal parenchyma, thereby not reducing the functional ability of the kidney. In addition, the outcomes and survival rates are quite high, making it an alternative option for other nephron-saving operations.

About the authors

Nikita A. Shchekuteev

N.N. Petrov National Medical Research Center of Oncology

Email: dr.shchekuteev@gmail.com
ORCID iD: 0000-0001-9625-3907
SPIN-code: 5837-8625

Oncologist

Russian Federation, 68, Leningradskaya st., Pesochnyj village, St. Petersburg, 197758

Alexander K. Nosov

N.N. Petrov National Medical Research Center of Oncology

Email: nakuro@yandex.ru
ORCID iD: 0000-0003-3850-7109
SPIN-code: 1711-1476

Cand. Sci. (Med.), Head of the Surgical Oncourogical Department, Senior Researcher

Russian Federation, 68, Leningradskaya st., Pesochnyj village, St. Petersburg, 197758

Georgiy G. Prohorov

N.N. Petrov National Medical Research Center of Oncology

Email: gprokhorov@mail.ru
ORCID iD: 0000-0001-9015-3817
SPIN-code: 9166-4705

Dr. Sci. (Med.), Professor, Leading Researcher

Russian Federation, 68, Leningradskaya st., Pesochnyj village, St. Petersburg, 197758

Ilia A. Burovik

N.N. Petrov National Medical Research Center of Oncology

Author for correspondence.
Email: burovick_ilya@mail.ru
ORCID iD: 0000-0002-4714-1228
SPIN-code: 1923-6457

MD, Cand. Sci. (Med.), Radiologist

Russian Federation, 68, Leningradskaya st., Pesochnyj village, St. Petersburg, 197758

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Supplementary files

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2. Fig. 1. Functional capacity of the kidney in patients with localized kidney cancer before and after cryoablation (n = 56)

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3. Fig. 2. Survival rates of patients after cryoablation of localized kidney cancer (n = 56)

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