Mp44-15 Percutaneous Cryoablation of Renal Cell Carcinomas in Patients With Von Hippel-Lindau Disease: Functional and Oncological Outcomes

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy III (MP44)1 May 2024MP44-15 PERCUTANEOUS CRYOABLATION OF RENAL CELL CARCINOMAS IN PATIENTS WITH VON HIPPEL-LINDAU DISEASE: FUNCTIONAL AND ONCOLOGICAL OUTCOMES Akihiro Matsukawa, Takafumi Yanagisawa, Kanichiro Shimizu, Shahrokh F. Shariat, and Takahiro Kimura Akihiro MatsukawaAkihiro Matsukawa , Takafumi YanagisawaTakafumi Yanagisawa , Kanichiro ShimizuKanichiro Shimizu , Shahrokh F. ShariatShahrokh F. Shariat , and Takahiro KimuraTakahiro Kimura View All Author Informationhttps://doi.org/10.1097/01.JU.0001009508.69111.d0.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Von Hippel-Lindau (VHL) disease is an inherited syndrome that predisposes individuals to multiple tumors, including renal cell carcinomas (RCCs), which occur in up to 45% of patients. RCCs in VHL are juvenile-onset, multifocal, and metachronous, requiring repeated surgeries that can make subsequent surgeries more challenging and increase the risk of complications. Image-guided ablation therapy (AT), including percutaneous cryoablation (PCA) and radiofrequency ablation (RFA), seem reasonable treatment options for multiple small RCCs associated with VHL; however, no study reported the efficacy of PCA in a large cohort. Therefore, this study aims to evaluate the safety, efficacy, and renal function preservation of PCA for small RCCs associated with VHL. METHODS: We retrospectively analyzed the records of 14 VHL patients who underwent PCA between February 2014 and June 2022 at our institution. Assessment of technique efficacy, residual tumor, local tumor recurrence, and eGFR preservation was conducted. RESULTS: For 40 tumors with 14 VHL patients (8 males, 6 females), PCA was performed with a median tumor size of 23.0 mm (IQR: 17.75- 27.25 mm) and the median R.E.N.A.L nephrometry score was 7 (IQR: 6-8). No patients required RN or PN during the median follow- up period; 57.5 (IQR: 25.0-76.5) months. The median hospital stay after PCA was 2.0 (IQR: 2.0-3.0) days. One patient (1/41, 2.4%) experienced a severe complication (pneumothorax, Clavien-Dindo Grade IIIa). Only one patient required a salvage PCA due to a residual tumor, which finally resulted in adequate local control. No other local disease recurrence or metastasis was observed during the follow-up period. The median baseline eGFR (prior to initial PCA) was 69.0 (IQR: 59.8–88.7) ml/min/1.73 m2, and the median eGFR at the last visit was 57.4 (IQR: 41.3-79.2) ml/min/1.73 m2 (p=0.2). CONCLUSIONS: Our study demonstrated that PCA is a safe and effective treatment option for RCCs in VHL patients with favorable oncological outcomes while preserving renal function. PCA can be performed repeatedly, regardless of prior treatments, making it an attractive option for patients with concurrent or metachronous multifocal, slow-growing small renal masses. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e736 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Akihiro Matsukawa More articles by this author Takafumi Yanagisawa More articles by this author Kanichiro Shimizu More articles by this author Shahrokh F. Shariat More articles by this author Takahiro Kimura More articles by this author Expand All Advertisement PDF downloadLoading ...