Percutaneous cryoablation of localized T1a renal cell carcinoma (RCC) provides long-term oncologic control with a low rate of complications, according to a podium presentation at the American Urological Association’s 2023 Annual Meeting.
At 5 years after percutaneous cryoablation, the overall survival rate was 87%, the cancer-specific survival rate was 100%, and the recurrence-free survival rate was 88% among patients without residual disease, Taigo Kato, MD, PhD, of Osaka University in Japan, reported.
Of the 97 patients studied, 71 received CT-guided percutaneous cryoablation as initial therapy and 26 as treatment for local recurrence of small RCC. Twenty-seven percent of patients had an ASA Physical Status score of III, and 49% had comorbidities.
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According to biopsy results at 3 months after cryoablation in 88 patients, 2 patients had residual cancer and 6 patients experienced recurrence. The rate of grade 3 complications was 2.0%.
In an immunohistochemistry analysis following cryoablation in 22 patients, the investigators confirmed a significant increase in CD8 T and CD11c cells infiltrating renal tissues, which may play a role in controlling tumor progression.
The mean estimated glomerular filtration rate (eGFR; in mL/min/1.73 m2) declined from 52.8 at baseline to 48.3 at 3 months after cryoablation, then stabilized. A logistic regression analysis showed that greater tumor complexity, indicated by a R.E.N.A.L nephrometry score greater than 7 (vs less than 7), was significantly associated with 3-fold increased odds of a more than 20% decline in eGFR.
“Percutaneous ablation appears to be a reasonable option for patients with high comorbidity at presentation,” Dr Kato said. “Our findings revealed that cryoablation could induce strong immune reactions in tumors with oligoclonal expansion of antitumor T cells, which circulate systemically.”
Reference
Kato T, Okuda Y, Ono Y, et al. Clinical outcomes and immune response of percutaneous cryoablation for localized renal cell carcinoma: experience in clinical practice in Japan. Presented at: AUA 2023, Chicago, Illinois, April 28-May 1. Presentation PD07-08.
This article originally appeared on Renal and Urology News
