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Transarterial embolization of T1b and T2a renal cell carcinoma prior to percutaneous cryoablation: a retrospective comparative study

  • Interventional Radiology
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Abstract

Purpose

To compare outcomes in patients with T1b and T2a renal cell carcinoma (RCC) treated with percutaneous cryoablation (PCA) who underwent transarterial embolization (TAE) of the RCC prior to PCA (TAE + PCA) to patients who were treated with PCA alone.

Methods

Retrospective review of all adult patients with T1b (4.1–7 cm) and T2a (7.1–10 cm) RCC treated with PCA from 2008 to 2021. Data collected included age, sex, tumor diameter, RENAL nephrometry score, technical success, adverse events (AEs), changes in serum creatinine, local control, and recurrence rates. A p value of 0.05 was considered the threshold for statistical significance.

Results

13 patients with 13 RCCs (mean age: 72.7 ± 10.4; 54% male) and 35 patients with 37 RCCs (mean age: 66.7 ± 10.6; 60% male) were included in the TAE + PCA and PCA groups, respectively. The TAE + PCA group had larger mean tumor diameter (5.7 ± 1.1 cm vs. 4.7 ± 0.6 cm; p < 0.0001) and higher mean RENAL nephrometry score (8.9 ± 1.1 vs. 7.8 ± 1.5; p = 0.02). There were no differences between the groups with respect to technical success of PCA (p = 0.46), local tumor control (p = 0.3), or mean number of procedures to achieve local tumor control (p = 0.85). Mean increase in serum creatinine was not significantly different between the two groups (p = .63). Major AEs were similar between the groups (p = 1); however, the TAE + PCA group had no major hemorrhagic AEs while the PCA alone group had three (8.3%).

Conclusion

TAE + PCA in patients with T1b or T2 RCC is technically feasible without significant added detriment to renal function. This combined approach may help to reduce hemorrhagic AEs but larger patient cohorts are needed.

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Acknowledgements

Findings from this investigation were presented as an oral scientific abstract at the Society of Interventional Radiology Annual Scientific Meeting in June 2022. The preliminary abstract can be found in a June 2022 supplementary issue of the Journal of Vascular of Interventional Radiology.

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Authors and Affiliations

  1. Division of Vascular and Interventional Radiology, Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA

    Aliaksei Salei, Junjian Huang & Theresa M. Caridi

  2. Heersink School of Medicine, University of Alabama at Birmingham, 619, 19Th St S, NHB 623, Birmingham, AL, 35249, USA

    Matt Raymond, Cody Savage & Andrew J. Gunn

  3. Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA

    Soroush Rais-Bahrami

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  1. Aliaksei Salei
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  2. Matt Raymond
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Correspondence to Andrew J. Gunn.

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Conflicts of interest

Dr. Huang is a consultant for Varian Medical Systems; Dr. Caridi is a consultant and speaker for Varian Medical Systems and Boston Scientific Corporation; Dr. Gunn is a consultant and speaker for Varian Medical Systems and Boston Scientific Corporation and receives grant funding from Penumbra, Inc and Varian Medical Systems.

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Salei, A., Raymond, M., Savage, C. et al. Transarterial embolization of T1b and T2a renal cell carcinoma prior to percutaneous cryoablation: a retrospective comparative study. Abdom Radiol 48, 773–779 (2023). https://doi.org/10.1007/s00261-022-03755-3

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