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Percutaneous Cryoablation for Renal Cell Cancer • Christos Georgiades MD PhD • Assistant Professor of Radiology & Surgery • Vascular & Interventional Radiology • Johns Hopkins Hospital Stamping Out Kidney Cancer Without Surgery • 55,000 patients are diagnosed with kidney cancer every year in the US…and increasing 08 20 . 03 20 . 00 . 20 50 19 • 75% of them are discovered by accident and most small enough to be treated by Interventional Radiology (Avoid Surgery) 60000 50000 40000 30000 20000 10000 0 How is Cryoablation done? Skin Tumor 1. No incision/No surgery 2. No general anesthesia Kidney Needle 3. Ablation needle(s) placed by Interventional Radiologist under Image guidance Our 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 Results -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 Tumor 1-Year 2-Years 3-Years Summary • 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. Conclusions • 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)