Imaging and Nonsurgical Management of Renal Masses.

In patients with renal masses, when intervention is warranted, partial nephrectomy is preferred when feasible, especially for T1 renal masses. Thermal ablation, however, has become an accepted alternative treatment of small renal neoplasms with excellent oncologic outcomes. The National Comprehensive Cancer Network guidelines include thermal ablation as a treatment strategy for managing T1a and select T1b masses.

Percutaneous Cryoablation of Plasmacytomas: Oncologic Effectiveness and Adverse Events.

Purpose: To evaluate the oncologic outcomes and adverse events associated with cryoablation of plasmacytomas.

Materials And Methods: Retrospective review of an institutional percutaneous ablation database showed that 43 patients underwent 46 percutaneous cryoablation procedures for treatment of 44 plasmacytomas between May 2004 and March 2021. The treatment of 25 (25 of 44, 56.

Safety and Effectiveness of Transhepatic Access for Percutaneous Renal Mass Cryoablation: A Multicenter Cohort.

Purpose: To establish transhepatic percutaneous cryoablation of renal masses as a safe and effective approach.

Materials And Methods: A retrospective review of records from 3 separate medical centers was performed identifying 23 patients (median age, 63 years [range 41-84 years]; 12 female [52.2%]) who underwent percutaneous transhepatic cryoablation for right-sided renal masses (median diameter, 2.

Safety and Efficacy of Percutaneous Image-Guided Mediastinal Mass Core-Needle Biopsy.

Objective: To retrospectively evaluate the safety and efficacy of percutaneous image-guided mediastinal mass core-needle biopsy.

Patients And Methods: Retrospective review of an institutionally maintained biopsy registry identified 337 computed tomography- or ultrasound-guided percutaneous mediastinal mass core needle biopsies between October 2002 and August 2017 in a single quaternary referral center. Mean patient age was 51 (range, 18 to 93) years.

A Clinical Decision Aid to Support Personalized Treatment Selection for Patients with Clinical T1 Renal Masses: Results from a Multi-institutional Competing-risks Analysis.

Background: Personalized treatment for clinical T1 renal cortical masses (RCMs) should take into account competing risks related to tumor and patient characteristics.

Objective: To develop treatment-specific prediction models for cancer-specific mortality (CSM), other-cause mortality (OCM), and 90-d Clavien grade ≥3 complications across radical nephrectomy (RN), partial nephrectomy (PN), thermal ablation (TA), and active surveillance (AS).

Design, Setting, And Participants: Pretreatment clinical and radiological features were collected for consecutive adult patients treated with initial RN, PN, TA, or AS for RCMs at four high-volume referral centers (2000-2019).

Percutaneous Cryoablation of Large Tumors: Safety, Feasibility, and Technical Considerations.

Introduction: Large tumors may prove unsuitable for surgical cure or other local therapies due to their size, involvement of critical structures, prior non-ablative treatment failure, or coexisting disease burden. This study was performed to assess the safety and feasibility of percutaneous cryoablation for treatment of large tumors exceeding 6 cm in size, and to highlight the key technical considerations inherent to such cases.

Materials And Methods: This single-institution retrospective study identified 77 patients (42 male, 35 female; median age 55 years) who underwent 96 cryoablation procedures for treatment of 78 tumors (mean diameter 9.

Safety and Efficacy of Retrograde Pyeloperfusion for Ureteral Protection during Renal Tumor Cryoablation.

Purpose: To determine safety and efficacy of retrograde pyeloperfusion for ureteral protection during cryoablation of adjacent renal tumors.

Materials And Methods: Retrospective review of 155 patients treated with renal cryoablation, including adjunctive retrograde pyeloperfusion, from 2005 to 2019 was performed. Ice contacted the ureter in 67 of the 155 patients who represented the study cohort.

Safety and Efficacy of Percutaneous Image-guided Cryoablation of Completely Endophytic Renal Masses.

Objective: To evaluate the safety, efficacy, and oncologic control of percutaneous image-guided cryoablation in the treatment of completely endophytic renal masses. Percutaneous image-guided cryoablation is a minimally invasive and effective treatment for small renal masses. Image-guided cryoablation is an attractive treatment for completely endophytic tumors given the challenge in visualization of such lesions during surgical extirpation.

Oncologic Outcomes Following Partial Nephrectomy and Percutaneous Ablation for cT1 Renal Masses.

Background: Long-term data comparing partial nephrectomy (PN) and thermal ablation are lacking.

Objective: To update our experience with PN, percutaneous radiofrequency ablation (RFA), and percutaneous cryoablation for cT1 renal masses.

Design, Setting, And Participants: A total of 1798 patients with primary cT1N0M0 renal masses treated between 2000 and 2011 at Mayo Clinic were identified.

Frequency of Bleeding Complications After Percutaneous Core Needle Biopsy and the Association With Aspirin Usage and Length of Aspirin Discontinuation.

The purpose of this study is to report the frequency of major bleeding after percutaneous image-guided core biopsy and its association with aspirin usage and duration of prebiopsy aspirin abstinence. A retrospective review of percutaneous image-guided core biopsies performed at our institution between September 1, 2005, and September 1, 2016, was performed ( = 30,966). Patients were excluded if aspirin usage data were missing ( = 633).

Risk factors associated with significant bleeding events after ultrasound-guided percutaneous native renal biopsies: a review of 2204 cases.

Objective: To review the incidence of significant bleeding complications after ultrasound-guided percutaneous core native renal biopsies at a single center using a standardized technique.

Materials And Methods: A retrospective review of ultrasound (US)-guided percutaneous native renal core biopsies done at our institution from September 2005 to December 2015 was performed. Demographic and clinical data were collected at the time of biopsy, with additional clinical information recorded 24 h and 3 months after the biopsy.

Effectiveness and Safety of Percutaneous CT-Guided Rib Biopsy.

Purpose: To retrospectively evaluate effectiveness and safety of percutaneous CT-guided rib biopsy.

Materials And Methods: CT-guided core rib biopsies were performed in 249 consecutive patients between January 2002 and June 2016. Mean patient age was 64.

Introduction of Microwave Ablation Into a Renal Ablation Practice: Valuable Lessons Learned.

Objective: The purpose of this study was to evaluate the early outcomes of percutaneous microwave ablation (MWA) for clinical stage T1 (cT1) renal masses when performed within a high-volume ablation practice with critical emphasis on procedural safety.

Materials And Methods: A retrospective review of a percutaneous renal ablation registry identified 26 patients with a total of 27 cT1 renal masses treated with MWA between 2011 and 2017. Mean patient age was 63.

Impact of a 3D printed model on patients' understanding of renal cryoablation: a prospective pilot study.

Purpose: To determine whether a 3D printed model improves patients' understanding of renal cryoablation and the involved anatomy.

Methods: This prospective study included 25 control patients, who received standard of care renal cryoablation education (verbal explanation accompanied by review of relevant 2D imaging) and 25 experimental patients, who received education using a 3D printed renal cryoablation model in addition to standard of care. Subsequent patient surveys included 5 anatomy and 5 procedural knowledge questions.

Palliative Percutaneous Cryoablation and Cementoplasty of Acetabular Metastases: Factors Affecting Pain Control and Fracture Risk.

Purpose: To characterize the response of patients with acetabular metastases following combined cryoablation and cementoplasty (CCC) for pain palliation and fracture risk reduction, based on completeness of ablation and the presence of pre-existing pathologic fracture.

Materials And Methods: Thirty-nine consecutive acetabular CCC procedures were performed in 37 patients (24 M:13F, age 66 ± 8 years). Pain was assessed using a 0-10 numeric rating scale.

Synchronous nephron-sparing approaches for bilateral renal masses: peri-operative and renal functional outcomes.

Objectives: To evaluate the peri-operative and renal functional outcomes of patients undergoing synchronous bilateral partial nephrectomy (PN) or percutaneous cryoablation (PCA).

Patients And Methods: We retrospectively reviewed our institutional nephrectomy and renal mass ablation registries to identify all patients with synchronous bilateral renal masses who underwent simultaneous bilateral PN (n = 76) or PCA (n = 13) between 1974 and 2013. Changes in estimated glomerular filtration rate (eGFR) as well as peri-operative complications are descriptively reported for each procedure.

Imaging following renal ablation: what can we learn from recurrent tumors?

Purpose: The purpose of the study was to evaluate the post-contrast appearance of local tumor progression (LTP) following renal ablation to better understand patterns of tumor recurrence and to optimize follow-up imaging protocols.

Methods: From 2002 to 2015, 913 patients underwent 988 renal ablation procedures for treatment of 1064 tumors. LTP was identified in 24 (2.

A Comparison of Bleeding Complications in Patients Undergoing Percutaneous Renal Cryoablation Using Cryoprobes with and without Heat-Based Track Ablation.

Purpose: To determine if the use of heat-based track ablation with new-generation cryoprobes is associated with decreased renal cryoablation bleeding complications.

Materials And Methods: Eighty-nine patients who underwent percutaneous cryoablation for treatment of a solitary renal mass with the use of cryoprobes with track ablation (CwTA) from October 29, 2015, to May 18, 2017, were compared with a propensity score-matched control group of 178 patients who underwent treatment with the use of cryoprobes without track ablation (Cw/oTA) from January 5, 2012, to October 28, 2015. Bleeding complications were assessed with the use of the Clavien-Dindo classification system and compared between the matched patient groups by means of conditional logistic regression, both univariately and in a multivariate model to adjust for imbalanced covariates.

Percutaneous Cryoablation of Renal Cell Carcinoma with Sinus Vein Involvement Based on Preprocedural Imaging.

Purpose: To assess feasibility, safety, and oncologic outcomes of cryoablation in treatment of renal cell carcinoma (RCC) with extension into adjacent renal sinus vein.

Materials And Methods: Review of an internally maintained renal ablation registry identified 7 patients (4 men and 3 women; median age 62 y; age range, 45-91 y) who underwent percutaneous cryoablation of RCC with imaging consistent with extension of tumor into an immediately adjacent renal sinus vein. Four of 7 (57%) patients had recurrent tumors following prior partial nephrectomy.

Outcomes After Cryoablation Versus Partial Nephrectomy for Sporadic Renal Tumors in a Solitary Kidney: A Propensity Score Analysis.

Background: While partial nephrectomy (PN) is considered the standard approach for a tumor in a solitary kidney, percutaneous cryoablation (PCA) is emerging as an alternative nephron-sparing option.

Objective: To compare outcomes between PCA and PN for tumors in a solitary kidney.

Design, Setting, And Participants: Patients who underwent PCA or PN between 2005 and 2015 for a single primary renal tumor in a solitary kidney were identified using Mayo Clinic Registries.