Tommy Kjærgaard Nielsen

Oncologic outcomes and complication rates after laparoscopic-assisted cryoablation: a EuRECA multi-institutional study

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

DOI

  • Tommy Kjaergaard Nielsen
  • Brunolf W Lagerveld
  • ,
  • Francis Keeley
  • ,
  • Giovanni Lughezzani
  • ,
  • Seshadri Sriprasad
  • ,
  • Neil J Barber
  • ,
  • Lars Ulrich Hansen
  • ,
  • Nicole Maria Buffi
  • ,
  • Giorgio Guazzoni
  • ,
  • Johan A van der Zee
  • ,
  • Mohamed Ismail
  • ,
  • Khaled Farrag
  • ,
  • Amr M Emara
  • ,
  • Lars Lund
  • Øyvind Østraat
  • ,
  • Michael Borre

OBJECTIVE: To assess complication rates and intermediate oncologic outcomes of laparoscopic-assisted cryoablation (LCA) in patients with small renal masses (SRM).

PATIENTS AND METHODS: A retrospective review of 808 patients treated with LCA for T1a renal masses from 2005 to 2015 at eight European institutions. Complications were analysed according to the Clavien-Dindo classification. Kaplan-Meier analyses were used to estimate 5 and 10-year disease-free survival (DFS) and overall survival (OS).

RESULTS: Median age was 67 years (IQR: 58-74). Median tumour size was 25mm (IQR: 19-30). The transperitoneal approach was used in 77.7% of the patients. Median postoperative hospital stay was two days. A total of 514 patients with a biopsy-confirmed RCC were available for survival analyses. Median follow-up time for the RCC-cohort was 36 months (IQR: 14-56). A total of 32 patients (6.2%) were diagnosed with treatment failure. The 5/10-year DFS was 90.4%/80.0% and 5/10-year OS was 83.2%/64.4%, respectively. A total of 134 postoperative complications (16.6%) were reported, with severe complications (grade ≥ 3) in 26 patients (3.2%). An ASA score of three was associated with an increased risk of overall complications (OR: 2.85; 95%CI: 1.32-6.20; p=0.005).

CONCLUSIONS: This large series of LCA demonstrates satisfactory long-term oncologic outcomes for SRMs. However, although LCA is considered a minimally invasive procedure, risk of complications should be considered when counselling patients. This article is protected by copyright. All rights reserved.

OriginalsprogEngelsk
TidsskriftB J U International (Online)
Vol/bind119
Nummer3
Sider (fra-til)390–395
Antal sider6
ISSN1464-410X
DOI
StatusUdgivet - mar. 2017

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