Percutaneous Cryoablation of T1A Renal Cell Carcinoma: Functional Outcomes and Residual Disease Management

Abstract

Objective: This retrospective cohort study evaluated the efficacy, safety, and functional outcomes of percutaneous cryoablation in T1a renal cell carcinoma (RCC), with an emphasis on residual disease management and radiological follow-up.

Materials and Methods: Thirteen patients with 15 T1a RCC lesions treated with percutaneous cryoablation between September 2023 and June 2024 were retrospectively analyzed. Clinical and follow-up data were collected. All procedures were performed under CT and US guidance using a standardized double freeze–thaw protocol. Follow-up included renal function assessment and radiological imaging with MRI or CT at the 3^rd month, 6^th month, and 1 year.

Results: The study included 11 males (84.6%) and 2 females, with a median age of 62 years (range, 50-71 years). The median tumor diameter was 22 mm, and the PADUA score was 8. The median number of cryoablation probes used per procedure was 2 (range, 1-3), and the median procedural time was 60 minutes. Complete ablation was achieved in most patients; however, residual disease was detected in three patients during follow-up. Among those with residual disease, one underwent repeat cryoablation, one underwent surgery, and one underwent active surveillance. Complications were minor, including a single hematoma and one intracystic hemorrhage, both of which were asymptomatic. Renal function was preserved throughout the follow-up period, including in solitary kidney patients, with no clinically significant eGFR decline.

Conclusion: Percutaneous cryoablation achieved local tumor control with preservation of renal function and a low complication rate during follow-up in patients with T1a RCC.

Keywords

• Magnetic resonans imaging
• percutaneous cryoablation
• renal cell carcinoma
• renal function preservation
• treatment outcome

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