Percutaneous CT-Guided Cryoablation of T1b Renal Cell Carcinoma: A Retrospective Study of Efficacy and Safety

Purpose: The incidence of renal cell carcinoma (RCC) has risen in recent decades, mainly due to the widespread use of diagnostic imaging. Percutaneous cryoablation (PCA) is minimally invasive, making it favorable if surgery is contraindicated. This study evaluates the oncological efficacy and safety of PCA as a treatment for T1b RCC. Material and Methods: This retrospective study included 35 patients with T1b RCC treated with PCA. Patients were included if they had at least 3 years of follow-up. Oncological outcomes were analyzed using descriptive statistics and Kaplan–Meier survival curves. Furthermore, estimated glomerular filtration rate (eGFR) changes were described, and postoperative complications were graded according to the Clavien–Dindo classification. Results: The primary efficacy rate was 68.6%, with a median follow-up time of 34.7 months (range: 0–66.5 months), and the secondary efficacy rate was 77.1%, with a mean follow-up time of 41.6 months (range: 0–66.5 months). After primary PCA, 17.1% (n = 6) were incomplete. Local tumor progression was found in 14.3% (n = 5) of patients. The disease-free survival rates at 1, 3, and 5 years were 80.0%, 69.3%, and 60.0%, respectively. Four patients (11.4%) progressed from localized RCC to metastatic disease. The average decline in eGFR was 6.7 mL/min/1.73 m² 1 year after PCA. Complications were observed in 11.4% (n = 4) of patients. Conclusion: This study found that treating T1b RCC with PCA was challenging. Local tumor control rates were low, and the risk for metastatic progression was high. However, PCA demonstrated a commendable safety profile, with few complications and good preservation of kidney function. Level of Evidence: 3, a retrospective cohort study.