Long-term oncologic outcomes of laparoscopic renal cryoablation as primary treatment for small renal masses

Introduction: Data regarding long-term oncologic outcomes of laparoscopic renal cryoablation (LRC) as first treatment for small renal masses (SRMs) are lacking. We hypothesized that LRC might provide an effective long-term cancer control in patients with a single cT1a SRM without a previous history of renal cell carcinoma (RCC). Materials and methods: The study design was a retrospective analysis of 174 consecutive patients who received LRC as first treatment for a single computed tomography or magnetic resonance imaging contrast-enhancing cT1a SRM between 2000 and 2013. Patients with a previous history of RCC were excluded. Treatment failure was evaluated 1 day alter surgery. Local recurrence, metachronous SRM, systemic progression, disease relapse, cancer-specific mortality, and all-cause mortality were evaluated 10 years after surgery. Kaplan-Meier plots were used to depict outcome-free survival rate. Results: Median patient age was 66 years. Median tumor size was 20 mm. Median follow-up was 48 months. Among patients with biopsy proven RCC (63%, n = 109), the treatment failure free rate was 98%. The 10-year recurrence-free survival rate was 95% and the 10-year metachronous SRM free survival rate was 87% The 10-year systemic progression free survival rate was 100% and the 10-year disease relapse free survival rate was 81%. The cancer-specific mortality free survival rate was 100%, and the all-cause mortality free survival rate was 61%. Conclusions: LRC provides sale long-term cancer control in patients newly diagnosed with a single cT1a SRM. Treatment failure and local recurrence are uncommon. Systemic progression free survival and cancer-specific free survival are optimal. (C) 2014 Elsevier Inc. All rights reserved.