Preoperative Tyrosine Kinase Inhibitors Before Percutaneous Cryoablation for Clinical T1b Renal Tumors

• Published in: Curēus (Palo Alto, CA) Vol. 16; no. 5; p. e60345
• Main Authors: Iwatani, Kosuke, Kimura, Shoji, Urabe, Fumihiko, Matsukawa, Akihiro, Aikawa, Koichi, Yanagisawa, Takafumi, Shimizu, Kanichiro, Miki, Kenta, Kimura, Takahiro, Miki, Jun
• Format: Journal Article
• Language: English
• Published: Palo Alto Cureus Inc 15.05.2024; Cureus
• Subjects: Ablation; Biopsy; Case reports; Drug dosages; Embolization; Hematuria; Hypertension; Hypothyroidism; Jargon; Kidney cancer; Medical imaging; Oncology; Patients; Pneumothorax; Radiology; Surgery; Thrombocytopenia; Tumors; Ultrasonic imaging; Urogenital system; Urology; Israel
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.60345

PurposeTo treat renal cell carcinoma, local ablative therapy is a viable alternative treatment option. Traditionally, cryoablation has been used for the treatment of T1a renal tumors. However, recent technological developments have expanded its application to encompass select T1b renal tumors. Here, we present a retrospective study of the utilization of preoperative tyrosine kinase inhibitors (TKIs) to induce tumor shrinkage and achieve favorable outcomes in percutaneous cryoablation (PCA).MethodsWe retrospectively evaluated the data from nine patients with clinical T1b renal tumors who underwent PCA. Six patients with TKI pretreatment at our institution between 2016 and 2018 were included in the study. We evaluated the safety and efficacy of preoperative TKIs prior to PCA.ResultsAll patients received axitinib with a median treatment duration of 80.5 days (IQR: 49-85). All patients experienced tumor shrinkage (median: 13.5 mm; IQR: 7-16); five experienced downstaging to T1a following tumor shrinkage. There were no severe adverse events (common terminology criteria for adverse events (CTCAE) grade ≥ 3) in TKIs. After the discontinuation of TKIs for two weeks, all PCA procedures were performed successfully without any severe complications. During a median follow-up of 46 months, no local recurrence was observed in any of these cases.ConclusionIn cases with large renal tumors, TKI pretreatment prior to PCA had potential benefits in terms of tumor shrinkage and long-term local control rate. Further well-designed studies in larger populations are needed to validate our findings.