| Abstract [eng] |
Introduction. Lithuania is the world's leading country in renal cancer incidence and mortality. In the last decade, the detection of incidental renal masses has increased due to the popularity of abdominal computer tomography scans. Early treatment allowed better outcomes, whereas kidney function became a key determinant of patients survival. As a result, cryoablation as a nephron-sparing procedure has gained popularity. Indications for cryoablation could be further expanded with more high-quality data. The aim of this article is to present a clinical case of cryoablation, review the latest scientific literature and evaluate the oncological and functional outcomes of cryoablation. Clinical case. This paper presents clinical case of an 81-year-old patient. This case is notable as the tumor was discovered incidentally during a computed tomography scan prior to colorectal cancer treatment. Patient had stage II chronic kidney disease and numerous co-morbidities. Tumor size was 12 mm, but after observing its rapid growth cryoablation was performed. After the procedure, renal function remained unchanged throughout the follow-up period. Six months after treatment, follow-up computed tomography scan showed no evidence of tumor recurrence. Conclusions. Cryoablation is more effective in preserving renal function in elderly, highly comorbid or single kidney patients compared to radiofrequency or thermal ablation. Localization of tumor and number of cryoprobes used do not affect oncological outcomes of cryoablation treatment. Treatment of tumors larger than 3 cm or of T1b stage is characterized by high recurrence rates. After unsuccessful primary treatment, cryoablation is only effective for masses smaller than 3 cm, untreated by renal resection. |
