Renal Cryoablation Patient Presentation 2

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Renal Cryoablation Patient Presentation 2

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Renal Cryoablation Patient Presentation 2

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

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