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Renal Cryoablation

Renal Cryoablation. Renal Cryoablation. Morbidity Efficacy Cancer Free Survival (NED) Cancer Specific Survival Post renal cryoablation metastases. Morbidity. Deane and Clayman review (2006): n= 320, Major complications: < 1% Johnson et al (2004): multicenter of 139 patients:

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Renal Cryoablation

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  1. RenalCryoablation

  2. Renal Cryoablation • Morbidity • Efficacy • Cancer Free Survival (NED) • Cancer Specific Survival • Post renal cryoablation metastases

  3. Morbidity Deane and Clayman review (2006): n= 320, Major complications: < 1% Johnson et al (2004): multicenter of 139 patients: Major: n = 2 (1 %) Significant hemorrhage : n=1 Conversion from laparoscopic to open: n=1 Minor: n = 17 (12 %) Transient probe site pain: n=10 Post-op UTI: n=2 Post-op pneumonia infection: n=2 Minor hemorrhage: n=1 Wound infection: n=1 Respiratory difficulty: n=1 Deane LA & Clayman RC, Urology 2006 68 (Suppl 1A): 26-37 Johnson et al J Urology 2004; 172 pp 874-877

  4. Efficacy • Cancer free survival (no pathologic evidence of disease) • Cancer specific survival (RCC specific) • Post cryoablation metastases

  5. Cancer Free Survival Following Renal Cryoablation 97.5%5* 96.6%3 96.4%1 100 95%2 95%4 93.3%6 80 60 Percent 40 20 0 4-years 5-years 3-years 1. Gill et al, J Urol. 2005 Jun;173(6):1903-7; 2. Harmon et al (Rukstalis), Presented at the 2004 AUA; 3. Begun et al, Journal of Urology 2006 175: 1225-1229; 4. Hasan et al (Gill), Presented at the 2004 AUA; 5. Davol et al (Rukstalis), Urology 2006 68 (Suppl 1A): 2-6; 6. Hegarty et al (Gill), Presented at the 2006 AUA; * After one or more procedures 12.5% of patients required two procedures

  6. Cancer Specific Survival Following Renal Cryoablation 100%4 100%3 100%2 100%5 100%6 98%1 100 80 60 Percent 40 20 0 4-years 5-years 3-years 1. Gill et al, J Urol. 2005 Jun;173(6):1903-7; 2. Harmon et al (Rukstalis), Presented at the 2004 AUA; 3. Begun et al, Journal of Urology 2006 175: 1225-1229; 4. Hasan et al (Gill), Presented at the 2004 AUA; 5. Davol et al (Rukstalis), Urology 2006 68 (Suppl 1A): 2-6; 6. Hegarty et al (Gill), Presented at the 2006 AUA

  7. Comparison of Partial Nephrectomy and Cryoablation References: For Partial Nephrectomy: All studies quoted in Campbell’s Urology Table 75-15: “Results of nephron Sparing surgery for renal cell carcinoma” Study Sizes: 10 – 485 patients, Mean follow-up: 24 – 75 months For Cryoablation:

  8. Cryo vs. Partial Nephrectomy: Cancer Specific Survival 100 80 60 Percent 40 20 0 Cryoablation Partial Nephrectomy 1. Andrew C. Novick and Steven C. Campbell. Renal Tumors. In: Campbell’s Urology 8th Edition 2. Nicholas J. Hegarty, et al. 2006 Jul;68(1 Suppl):7-13. 3. Patrick E. Davol, et al. Urology. 2006 Jul;68(1 Suppl):2-6. 4. Lawatsch EJ, et al. J Urol. 2006 Apr;175(4):1225-9. 5. Nicholas J Hegarty, et al. Presented at the 2006 Annual Meeting of the American Urological Association, May 20-25, 2006, Atlanta Georgia 6. Gill IS, et al. J Urol. 2005 Jun;173(6):1903-7.

  9. Cryo vs. Partial Nephrectomy: LocalRecurrence Rate 10 8 6 Percent 4 2 0 Cryoablation Partial Nephrectomy 1. Andrew C. Novick and Steven C. Campbell. Renal Tumors. In: Campbell’s Urology 8th Edition 2. Nicholas J. Hegarty, et al. 2006 Jul;68(1 Suppl):7-13. 3. Patrick E. Davol, et al. Urology. 2006 Jul;68(1 Suppl):2-6. 4. Lawatsch EJ, et al. J Urol. 2006 Apr;175(4):1225-9. 5. Nicholas J Hegarty, et al. Presented at the 2006 Annual Meeting of the American Urological Association, May 20-25, 2006, Atlanta Georgia 6. Gill IS, et al. J Urol. 2005 Jun;173(6):1903-7.

  10. Metastases following renal cryoablation Table III of Deane and Clayman (2006) reviews all publications of renal cryoablation: Of 320 patients treated with cryoablation alone there exists not a single report of the development of post renal cryoablation metastases Immune response? Research is ongoing. Note: Gill had four patients die of metastatic RCC but they all had bilateral disease and prior to cryoablation had all undergone partial or radical nephrectomy Deane LA & Clayman RC, Urology 2006 68 (Suppl 1A): 26-37 Gill et al, J Urol. 2005 Jun;173(6):1903-7

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