1
|
Jensen CG, Dybdahl M, Valtersson J, Mussmann BR, Duus LA, Junker T, Pietersen PI, Lund L, Welch BT, Graumann O. Percutaneous Image-Guided Cryoablation of Endophytic Renal Cell Carcinoma. Cardiovasc Intervent Radiol 2024; 47:453-461. [PMID: 38483602 PMCID: PMC10997531 DOI: 10.1007/s00270-023-03633-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 11/22/2023] [Indexed: 04/07/2024]
Abstract
PURPOSE Endophytic renal cancer treatment is a challenge. Due to difficulties in endophytic tumor visualization during surgical extirpation, image-guided percutaneous cryoablation (PCA) is an attractive alternative. The minimally invasive nature of PCA makes it favorable for comorbid patients as well as patients in which surgery is contraindicated. Oncological outcomes and complications after PCA of endophytic biopsy-proven renal cell carcinoma (RCC) were reviewed in this study. MATERIALS AND METHODS Patients were included after a multidisciplinary team conference from January 2015 to November 2021. Inclusion criteria were endophytic biopsy-proven T1 RCC treated with PCA with one year of follow-up. Complications were reported according to the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) classification system and the Clavien-Dindo classification (CDC) system. Major complications were defined as a grade ≥ 3 according to the CDC. RESULTS Fifty-six patients were included with a total of 56 endophytic tumors treated during 61 PCA sessions. The median RENAL nephrometry score was 9 (IQR 2), and the mean tumor size was 25.7 mm (SD ± 8.9 mm). Mean hospitalization time was 0.39 (SD ± 1.1) days. At a mean follow-up of 996 days (SD ± 559), 86% of tumors were recurrence free after one PCA. No patients progressed to metastatic disease. According to the CIRSE classification, 10.7% (n = 6) had grade 3 complications, and 5.4% (n = 3) had CDC major complications. CONCLUSION This study demonstrates that PCA of endophytic biopsy-proven T1 RCC is safe with few major complications and excellent local tumor control rates at almost three-year mean follow-up. LEVEL OF EVIDENCE 3: Retrospective cohort study.
Collapse
Affiliation(s)
- Christian Greve Jensen
- Faculty of Health Sciences, Medicine, University of Southern Denmark (SDU), Odense, Denmark
- Research and Innovation Unit of Radiology - UNIFY, SDU, Odense, Denmark
| | - Marco Dybdahl
- Research and Innovation Unit of Radiology - UNIFY, SDU, Odense, Denmark
| | - John Valtersson
- Research and Innovation Unit of Radiology - UNIFY, SDU, Odense, Denmark
| | - Bo Redder Mussmann
- Research and Innovation Unit of Radiology - UNIFY, SDU, Odense, Denmark
- Department of Radiology, OUH, Odense, Denmark
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Louise Aarup Duus
- Research and Innovation Unit of Radiology - UNIFY, SDU, Odense, Denmark
- Department of Radiology, OUH, Odense, Denmark
| | - Theresa Junker
- Research and Innovation Unit of Radiology - UNIFY, SDU, Odense, Denmark
- Department of Urology, OUH, Odense, Denmark
| | - Pia Iben Pietersen
- Research and Innovation Unit of Radiology - UNIFY, SDU, Odense, Denmark
- Department of Radiology, OUH, Odense, Denmark
| | - Lars Lund
- Department of Urology, OUH, Odense, Denmark
| | - Brian T Welch
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Ole Graumann
- Faculty of Health Sciences, Medicine, University of Southern Denmark (SDU), Odense, Denmark.
- Research and Innovation Unit of Radiology - UNIFY, SDU, Odense, Denmark.
- Department of Radiology, Aarhus University, Arhus, Denmark.
- Aarhus University, Arhus, Denmark.
| |
Collapse
|
2
|
Valtersson J, Vogsen M, Graumann O, Pietersen PI. Image-guided percutaneous cryoablation of a solitary subpleural lung metastasis from breast cancer. BMJ Case Rep 2023; 16:e256256. [PMID: 37857535 PMCID: PMC10603477 DOI: 10.1136/bcr-2023-256256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
This case presents CT-guided percutaneous cryoablation as a treatment option in a patient with oligometastatic breast cancer who previously had received standard-of-care treatment for metastatic breast cancer. Before cryoablation, the patient received two systemic lines of therapy, several surgeries and radiotherapy for oligometastatic disease. The cryoablation was performed in a single 7 mm subpleural oligometastatic lesion 42 months after diagnosis of metastatic breast cancer. It was performed without complications, and the patient experienced no complaints or discomfort after the procedure. A 3-month, 6-month, 9-month and 12-month follow-up fluorodeoxyglucose-positron emission tomography/CT scans showed no sign of disease progression.
Collapse
Affiliation(s)
- John Valtersson
- UNIFY - Research and Innovation Unit of Radiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Marianne Vogsen
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - Ole Graumann
- Department of Radiology, Odense University Hospital, Odense, Denmark
- UNIFY - Research and Innovation Unit of Radiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Pia Iben Pietersen
- Department of Radiology, Odense University Hospital, Odense, Denmark
- UNIFY - Research and Innovation Unit of Radiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
3
|
Valtersson J, Rasmussen BS, Elgborn A, Lund L, Graumann O. One hour observation of patients after image-guided percutaneous renal mass biopsy. Acta Radiol Open 2022; 11:20584601221138555. [DOI: 10.1177/20584601221138555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 11/26/2022] Open
Abstract
Background Imaging-guided percutaneous biopsy of renal masses is regarded as safe and is widely used for histopathology diagnosis before treatment. Recommended observation time after tumour biopsy varies in international guidelines and the literature is sparse. Purpose To assess the effect of a 1-h post-biopsy observation time of percutaneous image-guided renal mass biopsy. Material and Methods This was a single-centre retrospective study. During January 2015 to September 2019, a total of 484 patients underwent renal mass biopsies. 4-h-observation-group: 178 patients and 1-h-observation-group 306 patients. All records were retrospectively reviewed, and data such as complications was obtained and compared between the two groups. Results A total complication rate of 4.5% ( n = 22) without any major complications (Cardiovascular and Interventional Radiological Society of Europe-grade (CIRSE) 5–6). Furthermore, a non-significant difference of 1.3% of the 1-h group and 3.4% in the 4-h group experiencing complications was found ( p = .18). A total biopsy-accuracy of 84% was observed. Conclusion This study shows that renal mass biopsy is safe with no major complications. This suggests that an outpatient approach with 1-h-observation time can be safely implemented for renal mass biopsy.
Collapse
Affiliation(s)
- John Valtersson
- Department of Radiology, Odense University Hospital (OUH), Odense C, Denmark
- Research and Innovation Unit of Radiology, University of Southern Denmark, Odense C, Denmark
| | - Benjamin S Rasmussen
- Department of Radiology, Odense University Hospital (OUH), Odense C, Denmark
- Research and Innovation Unit of Radiology, University of Southern Denmark, Odense C, Denmark
| | - Anders Elgborn
- Department of Radiology, Hospital of Southern Jutland, Aabenraa, Denmark
| | - Lars Lund
- Department of Urology, OUH, Odense C, Denmark
- Institute of Clinical Research, SDU, Odense C, Denmark
| | - Ole Graumann
- Department of Radiology, Odense University Hospital (OUH), Odense C, Denmark
- Research and Innovation Unit of Radiology, University of Southern Denmark, Odense C, Denmark
| |
Collapse
|