Oncological outcomes and complication rates after laparoscopic-assisted cryoablation: a European Registry for Renal Cryoablation (EuRECA) multi-institutional study

OBJECTIVE: To assess complication rates and intermediate oncological outcomes of laparoscopic-assisted cryoablation (LCA) in patients with small renal masses (SRMs).PATIENTS AND METHODS: A retrospective review of 808 patients treated with LCA for T1a SRMs from 2005 to 2015 at eight European institutions. Complications were analysed according to the Clavien-Dindo classification. Kaplan-Meier analyses were used to estimate 5- and 10-year disease-free survival (DFS) and overall survival (OS).RESULTS: The median [interquartile (IQR)] age was 67 (58-74) years. The median (IQR) tumour size was 25 (19-30) mm. The transperitoneal approach was used in 77.7% of the patients. The median postoperative hospital stay was 2 days. In all, 514 patients with a biopsy-confirmed renal cell carcinoma (RCC) were available for survival analyses. The median (IQR) follow-up for the RCC-cohort was 36 (14-56) months. A total of 32 patients (6.2%) were diagnosed with treatment failure. The 5-/10-year DFS was 90.4%/80.0% and 5-/10-year OS was 83.2%/64.4%, respectively. A total of 134 postoperative complications (16.6%) were reported, with severe complications (grade ≥III) in 26 patients (3.2%). An American Society of Anesthesiologists score of 3 was associated with an increased risk of overall complications (odds ratio 2.85, 95% confidence interval 1.32-6.20; P = 0.005).CONCLUSIONS: This large series of LCA demonstrates satisfactory long-term oncological outcomes for SRMs. However, although LCA is considered a minimally invasive procedure, risk of complications should be considered when counselling patients.© 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

OBJECTIVE:To assess complication rates and intermediate oncologic outcomes of laparoscopic-assisted cryoablation (LCA) in patients with small renal masses (SRM).PATIENTS AND METHODS:A retrospective review of 808 patients treated with LCA for T1a renal masses from 2005 to 2015 at eight European institutions. Complications were analysed according to the Clavien-Dindo classification. Kaplan-Meier analyses were used to estimate 5 and 10-year disease-free survival (DFS) and overall survival (OS).RESULTS:Median age was 67 years (IQR: 58-74). Median tumour size was 25mm (IQR: 19-30). The transperitoneal approach was used in 77.7% of the patients. Median postoperative hospital stay was two days. A total of 514 patients with a biopsy-confirmed RCC were available for survival analyses. Median follow-up time for the RCC-cohort was 36 months (IQR: 14-56). A total of 32 patients (6.2%) were diagnosed with treatment failure. The 5/10-year DFS was 90.4%/80.0% and 5/10-year OS was 83.2%/64.4%, respectively. A total of 134 postoperative complications (16.6%) were reported, with severe complications (grade ≥ 3) in 26 patients (3.2%). An ASA score of three was associated with an increased risk of overall complications (OR: 2.85; 95%CI: 1.32-6.20; p=0.005).CONCLUSIONS:This large series of LCA demonstrates satisfactory long-term oncologic outcomes for SRMs. However, although LCA is considered a minimally invasive procedure, risk of complications should be considered when counselling patients. This article is protected by copyright. All rights reserved.