2008 Annual Meeting Abstracts
Cryoablation Of Renal Fossa Recurrence Following Radical Nephrectomy
Kristina D. Suson, Michael Phelan
University of Maryland Medical Center, Baltimore, MD
Introduction - Renal fossa recurrence of renal cell carcinoma (RCC) following radical nephrectomy historically requires open surgical resection. The failure rate is high (50%), and the procedure is associated with a high morbidity. Cryoablation of a solitary, local recurrence may provide a minimally invasive alternative to open resection. We describe our experience in treating two patients experiencing fossa recurrence with percutaneous cryoablation.
Methods - We retrospectively reviewed medical records of two patients with renal fossa recurrence of RCC treated with percutaneous cryoablation.
Results - Two patients developed remote local recurrence following radical nephrectomy and underwent percutaneous cryoablation with 17-gauge needles and two freeze-thaw cycles. A 69 y/o male with a history of bilateral nephrectomy for clear cell carcinoma developed a 3.2 cm recurrence 6 years after surgery. He received percutaneous cryoablation with four needles. After nine months, the mass showed continued enhancement, and he underwent a second treatment for biopsy-proven clear cell carcinoma. Surveillance imaging for the past 18 months is free of residual disease. A 52 y/o male received percutaneous cryoablation with three needles for a 2.3 cm mass that recurred 17 months after radical nephrectomy for clear cell carcinoma. One year after cryoablation, he underwent surgical extirpation. He is currently receiving Sutent for metastatic disease. Both patients tolerated percutaneous cryoablation well and were discharged home within 24 hours.
Conclusions - Percutaneous cryoablation provides a minimally invasive intervention with low morbidity. However, the patient requires close follow-up and may require re-treatment.
