Diagnostic and Interventional Radiology (Mar 2024)

Effect of lipiodol marking before CT-guided cryoablation on the outcome of sporadic renal cell carcinoma

  • Yasuhiro Ushijima,
  • Daisuke Okamoto,
  • Nobuhiro Fujita,
  • Keisuke Ishimatsu,
  • Noriaki Wada,
  • Seiichiro Takao,
  • Ryo Murayama,
  • Masahiro Itoyama,
  • Kousei Ishigami

DOI
https://doi.org/10.4274/dir.2023.232381
Journal volume & issue
Vol. 30, no. 2
pp. 117 – 123

Abstract

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PURPOSEThis retrospective study evaluates the impact of preoperative lipiodol marking on the outcomes of computed tomography (CT)-guided cryoablation for histologically diagnosed sporadic renal cell carcinoma (RCC).METHODSThis study analyzed the data of 173 patients who underwent CT-guided cryoablation for histologically proven sporadic RCC at a single institution between April 2014 and December 2020. The local control rate (LCR), recurrence-free survival rate (RFSR), overall survival rate (OSR), changes in renal function, and complications in patients with (n = 85) and without (n = 88) preoperative lipiodol marking were compared.RESULTSThe 5-year LCR and 5-year RFSR were significantly higher in patients with lipiodol marking (97.51% and 93.84%, respectively) than in those without (72.38% and 68.10%, respectively) (P value <0.01, log-rank test). There were no significant differences between the two groups regarding the 5-year OSR (97.50% vs. 86.82%) or the deterioration in chronic kidney disease stage (12.70% vs. 16.43%). Grade ≥3 complications occurred in patients with lipiodol marking (n = 2, retroperitoneal hematoma and cerebral infarction in 1 patient each) and without (n = 5; urinary fistula in 2, colonic perforation in 2, urinary infection in 1).CONCLUSIONLipiodol marking before CT-guided cryoablation for sporadic RCC is a feasible approach to improving local control and RFS while mitigating the decline in renal function. Additionally, it may help reduce complications.

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