The Iceman Cometh :) Percutaneous Cryoablation of Clinical T2 Renal Masses

Percutaneous Cryoablation of Clinical T2 Renal Masses–(The Iceman Cometh)

Journal of Vascular and Interventional Radiology: JVIR

 

 TAKE-HOME MESSAGE— First lets be clear on the stage of these tumors. They were greater than 7 cm and no lymph nodes or metastasis existed. Also the sample size of this study is very small and is from a single institution and is a retrospective report on what some good enterprising radiologists tried against a tumor which is usually highly resistant to chemotherapy  and which is starting to see some responses from targeted molecular therapy and monoclonal antibodies ( all tried for the most part in nodal or metastatic disease. These were patients for whom the rimary therapy of stage 1 and 2 is surgery but were deemed not to be ideal surgical candidates
Many of the patients have arterial tumor blood supply  super selectively  mapped and then clotting of the tumor was attempted. A good portion did not. One can not say whether it helped or hindered( either RX) One can say what they did which is that at this institution they were able to map tumor blood supply and then through the skin freeze the entire tumor mass to death AND have some major consequences, no deaths and excellent survival. This institution is not the only one to try cryotherapy and obviously patients must be carefully selected and radiologists and supporting staff must be well trained and skilled- but the Iceman Cometh and the tumors went away without the GFR glomerular Filtration rate= renal function  being permanently or significantly impaired  ( Doc Kevin Ryan )
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