Freezing Tumors Can Replace Surgery for Some
Some say, though, that technique is overrated
(HealthDay News) -- A noninvasive technique that destroys kidney cancer tumors by freezing them offers some people a new treatment option.
Called cryoablation, the method eliminates the need for surgery in many people with kidney cancer and should be the new "gold standard" of treatment for tumors that are up to 4 centimeters in diameter, according to Dr. Christos Georgiades, an interventional radiologist at Johns Hopkins Hospital.
In cryoablation, doctors use high-tech imaging to pinpoint tumors and then insert small probes through the skin to deliver freezing cold to the tumor. The procedure, usually performed as a one-day outpatient treatment, is already widely used in hospitals throughout the United States.
Georgiades was lead author of a study that assessed the effectiveness of cryoablation in treating 73 renal-mass tumors (10 of them benign) in 68 people, who averaged 67 years old. Their tumors were re-checked three, six and 12 months after their procedures.
Cryoablation was 100 percent successful in destroying localized tumors up to 4 centimeters in diameter, the study found. The success rate was "nearly" 100 percent for tumors up to 7 centimeters (about 3 inches) in size and about 66 percent effective for tumors 10 centimeters (4 inches) in diameter.
During follow-up, the researchers found no signs of cancer having spread to areas outside the kidney. The findings were presented at a meeting of the Society of Interventional Radiology.
"Here we found that we can very successfully treat kidney cancer tumors, and get rid of them completely, essentially by freezing them," Georgiades told HealthDay.
But he added that, despite the high success rate for cryoablation, problems with kidney tumor location mean that there will always be people who require surgery.
"The great success we had with cryoablation [in this study] assumes that not only is the tumor small enough but also that we can successfully get to it from the outside with probes," Georgiades said. "Tumors that are too deep or too close to vital organs might not be targetable" with cryoablation and, instead, would require surgical treatment.
"But this problem would affect only maybe one-quarter to one-third of patients," he said. "For the rest, cryoablation should be the first option."
Not all experts agree that cryoablation should be the first choice for treating kidney tumors, however.
"To suggest that freezing should be the new 'gold standard' is ... very naive because the treatment of small renal masses is a highly complex area in kidney tumor management, and ablation is largely an investigative technique that simply has not yet been studied well," Dr. Paul Russo, an attending urologic oncological surgeon at Memorial Sloan-Kettering Cancer Center in New York City, told HealthDay.
He argued that the follow-up in the Hopkins study was too short.
"Almost nothing happens in the first year" after treatment, Russo said. "To assess the effectiveness of any kidney cancer treatment you really need active surveillance for at least a five-year period, which they didn't do."
Russo described the study's conclusions as "a huge overstatement."
"Freezing is just one treatment option," he said. "Nothing more."
On the Web
To learn more about kidney cancer treatments, visit the American Cancer Society.
SOURCES: HealthDay News; Christos Georgiades, M.D., Ph.D., interventional radiologist, Johns Hopkins Hospital, Baltimore; Paul Russo, M.D., attending urologic oncological surgeon, Memorial Sloan-Kettering Cancer Center, New York City, and professor, urology, Cornell University, Ithaca, N.Y.; March 9, 2009, presentations, Society of International Radiology annual meeting, San Diego
Author: Robert Preidt
Publication Date: March 31, 2010
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