1 / 10

Renal Cryoablation

Renal Cryoablation. Renal Cryoablation. Morbidity Efficacy Cancer Free Survival (NED) Cancer Specific Survival Post renal cryoablation metastases. Morbidity. Deane and Clayman review (2006): n= 320, Major complications: < 1% Johnson et al (2004): multicenter of 139 patients:

lgary
Download Presentation

Renal Cryoablation

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. RenalCryoablation

  2. Renal Cryoablation • Morbidity • Efficacy • Cancer Free Survival (NED) • Cancer Specific Survival • Post renal cryoablation metastases

  3. Morbidity Deane and Clayman review (2006): n= 320, Major complications: < 1% Johnson et al (2004): multicenter of 139 patients: Major: n = 2 (1 %) Significant hemorrhage : n=1 Conversion from laparoscopic to open: n=1 Minor: n = 17 (12 %) Transient probe site pain: n=10 Post-op UTI: n=2 Post-op pneumonia infection: n=2 Minor hemorrhage: n=1 Wound infection: n=1 Respiratory difficulty: n=1 Deane LA & Clayman RC, Urology 2006 68 (Suppl 1A): 26-37 Johnson et al J Urology 2004; 172 pp 874-877

  4. Efficacy • Cancer free survival (no pathologic evidence of disease) • Cancer specific survival (RCC specific) • Post cryoablation metastases

  5. Cancer Free Survival Following Renal Cryoablation 97.5%5* 96.6%3 96.4%1 100 95%2 95%4 93.3%6 80 60 Percent 40 20 0 4-years 5-years 3-years 1. Gill et al, J Urol. 2005 Jun;173(6):1903-7; 2. Harmon et al (Rukstalis), Presented at the 2004 AUA; 3. Begun et al, Journal of Urology 2006 175: 1225-1229; 4. Hasan et al (Gill), Presented at the 2004 AUA; 5. Davol et al (Rukstalis), Urology 2006 68 (Suppl 1A): 2-6; 6. Hegarty et al (Gill), Presented at the 2006 AUA; * After one or more procedures 12.5% of patients required two procedures

  6. Cancer Specific Survival Following Renal Cryoablation 100%4 100%3 100%2 100%5 100%6 98%1 100 80 60 Percent 40 20 0 4-years 5-years 3-years 1. Gill et al, J Urol. 2005 Jun;173(6):1903-7; 2. Harmon et al (Rukstalis), Presented at the 2004 AUA; 3. Begun et al, Journal of Urology 2006 175: 1225-1229; 4. Hasan et al (Gill), Presented at the 2004 AUA; 5. Davol et al (Rukstalis), Urology 2006 68 (Suppl 1A): 2-6; 6. Hegarty et al (Gill), Presented at the 2006 AUA

  7. Comparison of Partial Nephrectomy and Cryoablation References: For Partial Nephrectomy: All studies quoted in Campbell’s Urology Table 75-15: “Results of nephron Sparing surgery for renal cell carcinoma” Study Sizes: 10 – 485 patients, Mean follow-up: 24 – 75 months For Cryoablation:

  8. Cryo vs. Partial Nephrectomy: Cancer Specific Survival 100 80 60 Percent 40 20 0 Cryoablation Partial Nephrectomy 1. Andrew C. Novick and Steven C. Campbell. Renal Tumors. In: Campbell’s Urology 8th Edition 2. Nicholas J. Hegarty, et al. 2006 Jul;68(1 Suppl):7-13. 3. Patrick E. Davol, et al. Urology. 2006 Jul;68(1 Suppl):2-6. 4. Lawatsch EJ, et al. J Urol. 2006 Apr;175(4):1225-9. 5. Nicholas J Hegarty, et al. Presented at the 2006 Annual Meeting of the American Urological Association, May 20-25, 2006, Atlanta Georgia 6. Gill IS, et al. J Urol. 2005 Jun;173(6):1903-7.

  9. Cryo vs. Partial Nephrectomy: LocalRecurrence Rate 10 8 6 Percent 4 2 0 Cryoablation Partial Nephrectomy 1. Andrew C. Novick and Steven C. Campbell. Renal Tumors. In: Campbell’s Urology 8th Edition 2. Nicholas J. Hegarty, et al. 2006 Jul;68(1 Suppl):7-13. 3. Patrick E. Davol, et al. Urology. 2006 Jul;68(1 Suppl):2-6. 4. Lawatsch EJ, et al. J Urol. 2006 Apr;175(4):1225-9. 5. Nicholas J Hegarty, et al. Presented at the 2006 Annual Meeting of the American Urological Association, May 20-25, 2006, Atlanta Georgia 6. Gill IS, et al. J Urol. 2005 Jun;173(6):1903-7.

  10. Metastases following renal cryoablation Table III of Deane and Clayman (2006) reviews all publications of renal cryoablation: Of 320 patients treated with cryoablation alone there exists not a single report of the development of post renal cryoablation metastases Immune response? Research is ongoing. Note: Gill had four patients die of metastatic RCC but they all had bilateral disease and prior to cryoablation had all undergone partial or radical nephrectomy Deane LA & Clayman RC, Urology 2006 68 (Suppl 1A): 26-37 Gill et al, J Urol. 2005 Jun;173(6):1903-7

More Related