Cryoablation for recurrent renal tumors after primary nephron-sparing surgery using an innovative liquid nitrogen-based cryogenic device

Abstract

The growing use and improvement of imaging modalities has resulted in increased detection of renal tumors. The gold standard treatment of small renal masses is nephronsparing surgery. Such surgical intervention is associated with significant rate of local failure. The currently accepted treatment for local failure after nephron-sparing surgery is radical nephrectomy which is associated with very high complication rate as well as loss of functional renal parenchyma. The aim of the current study was to evaluate the safety, technical feasibility, oncologic success and functional preservation of percutaneous cryoablation using a new liquid nitrogen-based cryogenic device in patients with tumor recurrence after nephron-sparing surgery. We present seven patients with tumor recurrence after nephron-sparing surgery who underwent percutaneous cryoablation using ProSenseTM (IceCure Medical Ltd, Caesarea, Israel) under computerized tomography guidance. None of the treated tumor lesions demonstrated contrast enhancement or growth on follow up imaging indicating a 100% oncologic success. Only three adverse events were recorded, all were classified as low grade and resolved spontaneously. In conclusion, percutaneous cryoablation using the novel ProSenseTM device for recurrent renal tumors following nephron-sparing surgery is feasible and effective, with excellent renal function preservation and without major complications.