Laparoscopic renal cyroablation effective for small RCCs
medwireNews: Study findings support the primary use of laparoscopic renal cryoablation (LRC) for long-term disease control in patients with a newly diagnosed single clinical T1a small renal mass (SRM).
Alessandro Larcher (Università Vita-Salute San Raffaele, Milan, Italy) and colleagues retrospectively analysed data on 174 patients without a previous history of renal cell carcinoma (RCC) who were treated with LRC.
They found that for the 109 patients who had biopsy-proven RCC, the 10-year recurrence-free survival and the 10-year metachronous SRM-free survival rates were 95% and 87%, respectively.
Treatment failure, defined as inadequate covering of the lesion as detected by magnetic resonance imaging on postoperative day 1, was observed in two patients with biopsy-proven RCC resulting in a 98% treatment failure-free rate.
Additionally, all patients with biopsy-proven RCC remained free of systemic progression, defined as the presence of RCC anywhere but the ipsilateral or contralateral kidney. But disease relapse was recorded in 11 patients, resulting in a 10-year disease relapse-free survival rate of 81%, where disease relapse-free survival was defined by the authors as the simultaneous absence of treatment failure, local recurrence, metachronous SRM and systemic progression.
Larcher et al point out that disease relapse did not preclude secondary treatment and that most of the patients were further treated with nephron-sparing surgery, either secondary LRC or partial nephrectomy.
Writing in Urologic Oncology, the authors explain that the short-term oncological outcomes with LRC are known to be promising, but that studies assessing long-term outcomes are limited and based on small and heterogeneous samples. They add that their study “relies on the most stringent definition of patient population as well as of surgical outcomes and allows the most confounders-free evaluation of long-term oncologic outcomes after LRC as primary treatment for SRM in the largest cohort available to date.”
Larcher and colleagues therefore conclude that based on their observations, “primary LRC deserve[s] better consideration as a treatment option for SRM”.
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By Shreeya Nanda, Senior medwireNews Reporter