Percutaneous Cryoablation for Renal Cell Percutaneous Cryoablation for Renal Cell CancerCancer

• Christos Georgiades MD PhD• Assistant Professor of Radiology & Surgery

• Vascular & Interventional Radiology• Johns Hopkins Hospital

Stamping Out Kidney Cancer Without Stamping Out Kidney Cancer Without SurgerySurgery

• 55,000 patients are diagnosed with kidney cancer every year in the US…and increasing

0

10000

20000

30000

40000

50000

60000

• 75% of them are discovered by accident and most small enough to be treated by Interventional Radiology (Avoid Surgery)

How is Cryoablation done?How is Cryoablation done?

1. No incision/No surgery

2. No general anesthesia

3. Ablation needle(s) placed by Interventional Radiologist under Image guidance

Skin

Tumor

Kidney

Needle

Our ExperienceOur Experience

– Treated 90 tumors (in 84 patients)

2006-2008– 80 under sedation– 4 local anesthesia only– Never general anesthesia– Ages 35-90– Follow up every 3 months up to a year and

then annually

ResultsResults-Of the 90 tumors (1-10 centimeters)

• 88 completely treated without any evidence for cancer (98%)

• 2 had small tumor left (~1cm), one retreated with ablation and now no tumor left (99%)

• No patients developed new local cancer or metastatic cancer after ablation and none required surgery

1-Year 2-Years 3-Years

Tumor

SummarySummary• Cryoablation by Interventional Radiology has a near

100% success rate in treating kidney cancers up to 4 and probably up to 7 centimeters in size

• No incision/no surgery/no anesthesia

• Most patients go home same day and can resume normal activities quickly

• Fewer complications, lesser cost

• In the unlikely case cryoablation fails, patients can still have the surgery they would have in the first place.

ConclusionsConclusions

• Cryo-ablation should be the first treatment choice for patients whose kidney cancer is 4 centimeters or smaller.

and

• If a patient wishes to avoid or cannot have surgery, even larger lesions can be treated (near 100% success rate cancer up to 7 centimeters in size)