Interventional Oncology

Session: Educational Exhibit Presentations - Station 6: Interventional Oncology

Techniques in cryoablation of T1b and T2a renal cell carcinoma

Monday, March 6, 2023

5:30 PM – 5:35 PM

Location: Phoenix Convention Center, North Ballroom 120ABC, Poster Hall

Abstract Presenter(s)

Richard A. Pigg, BA (he/him/his)

Medical Student
UAB Heersink School of Medicine

Disclosure(s): Boston Scientific: Consultant (), Speaker's Bureau (); Penumbra: Research Grant or Support (); Varian: Consultant (), Research Grant or Support (), Speaker's Bureau ()

Author/Co-author(s)

Aliaksei Salei, MD (he/him/his)

Assistant Professor, Division of Interventional Radiology
UAB Hospital
MR

Matthew Raymond, BS

Medical Student
UAB Heersink School of Medicine
WP

William Parkhurst, MD

Assistant Professor, Division of Interventional Radiology
University of Alabama at Birmingham
Theresa Caridi, MD

Vice Chair and Division Director
University of Alabama At Birmingham
AG

Andrew Gunn, MD

Program Director IR/DR
University of Alabama At Birmingham

Disclosure(s):

Richard A. Pigg, BA: Boston Scientific: Consultant (), Speaker's Bureau (); Penumbra: Research Grant or Support (); Varian: Consultant (), Research Grant or Support (), Speaker's Bureau ()

Aliaksei Salei, MD: No financial relationships to disclose

Theresa Caridi, MD: Boston Scientific: Consultant (Ongoing), Speaking and Teaching (Ongoing); Cook Inc: Speaking and Teaching (Ongoing); PENUMBRA INC: Speaking and Teaching (Terminated); Terumo Medical: Speaking and Teaching (Ongoing); Trisalus Life Sciences: Advisory Committee or Review Panel Member (Ongoing); Varian Interventional Solutions: Speaking and Teaching (Ongoing)

Andrew Gunn, MD: Boston Scientific: Consultant (Ongoing), Speaking and Teaching (Ongoing); Penumbra: Research Grant Recipient (Ongoing); Varian: Consultant (Ongoing), Research Grant Recipient (Ongoing), Speaking and Teaching (Ongoing)

Learning Objectives:

To discuss approaches to percutaneous cryoablation (CA) in the treatment of patients with T1b and T2a renal cell carcinoma (RCC)

Background: The incidence of RCC has been increasing in the US since the 1990s. Accordingly, there has been a greater demand for treatment, and various treatment modalities have been developed. Percutaneous ablation is a curative option with similar outcomes to surgery. It is a preferred treatment modality in select patients, particularly those who are poor candidates for partial or radical nephrectomy. Current guidelines recognize CA as a curative treatment of RCC tumors staged T1a (< 4cm). However, several reports have demonstrated that CA may be a safe and effective option for larger tumors, staged T1b (4.1cm-7cm) and T2a (7.1-10cm). These larger tumors pose a higher risk of complication and potentially less favorable oncologic outcomes, thus warranting a review of CA treatment strategies and techniques.

Clinical Findings/Procedure Details:

In this educational exhibit, we will provide a review of clinical guidelines and literature comparing patient outcomes following CA and surgical treatment of RCC. We will also provide a pictorial review of CA strategies for ablating larger tumors, including approaches to probe placement, displacement techniques, and staged CA. Additionally, we will review evidence and considerations for transarterial embolization prior to CA. We will conclude with the strategies to manage and avoid the most common post procedural complications.

Conclusion and/or Teaching Points:

CA of T1b and T2a RCC can be a safe and effective treatment option. Operator considerations, such as planned probe placement, displacement techniques, pre-ablation transarterial embolization, and staged CA can optimize results. After viewing this exhibit, the viewer will better understand the literature on CA of RCC beyond T1a stage, approaches to CA of larger tumors, as well as management of post-procedural complications.