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Renal Cryoablation Patient Presentation 2

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Renal Cryoablation Patient Presentation 2

Renal Cryoablation Patient Presentation 2

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Transcript

  • 1. Cryoablation of Renal Tumors
  • 2. Renal Cancer – Basic Facts
    • 30,000 are diagnosed in US every year – 12,000 annual deaths
    • Kidney = 3% of all diagnosed cancers
    • Most often found in those 50-70 years of age (more often in males)
    • There are no blood tests for kidney cancer
    • Usually a renal “mass” is detected (incidentally or looked for due to symptoms)
    • Symptoms: pain (due to expanding kidney), palpability, blood in the urine
    • Cancer specific survival is 79-100 % (very high)
    • 10-20% of people have renal masses found on autopsy – not the cause of death.
  • 3. Renal Cancer Staging Stage 1 Stage 2 Stage 3 Stage 4
  • 4. Stage 1 Disease
    • Rarely symptomatic
    • Usually found incidentally on CT scan or ultrasound
    • Ideal cryosurgery candidate
    • Partial nephrectomy preferred over nephrectomy.
  • 5. Stage 2 Disease
    • Sometimes symptomatic
    • If lesion is less than 5cm, can still be treated very effectively with cryotherapy – regardless of location of tumor (mid-pole lesions and tumors near the renal artery are still treatable)
    • Still a candidate for partial nephrectomy as long as tumor is not a mid-pole lesion
  • 6. Stage 3 Disease
    • Often symptomatic
    • Lymph node involvement suggests metastasis.
    • Surgery still possible with adjunct treatment of chemotherapy and/or radiation therapy to treat lymph system
    • Surgery would constitute a Radical Nephrectomy
  • 7. Stage 4 Disease
    • Usually symptomatic
    • Lymph node and bone metastases indicate that surgery is no longer a curative option
    • Radiation therapy and chemotherapy become the primary treatment options
  • 8. Urologist Decision Tree Diagnosis Curative Therapy (tumor removal) Palliation (Metastasized cancer) Embolization Immunotherapy Partial Removal (tumor only) Complete Removal of Kidney
    • Nephrectomy
    • Radical
    • Simple
    Partial Nephrectomy Ablation HIFU Microwave Laser RF Cryoablation
  • 9. RENAL CRYOABLATION LAPAROSCOPIC APPROACH
    • RETROPERITONEAL APPROACH
    • Tumor localized with laparoscopic ultrasound probe
    • Cryoprobe inserted into tumor
    • Freeze 1cm larger than tumor with a double freeze / thaw cycle
    • Collagen plug inserted into defect
  • 10. Renal Cryoablation
    • Cryotherapy offers a very attractive option for patients diagnosed with renal lesions <5cm in size.
      • Very little blood loss
      • High success rates (95-98% published rates over several studies)
      • Short hospital stay
      • Minimal pain