Surgical cryoablation as an option for small renal masses in patients who are not ideal partial nephrectomy candidates: intermediate-term outcomes
Bibliographic record
Abstract
Objective: There has been increasing interest in surveillance andablative techniques for small renal masses (SRM), given the increasingnumber being diagnosed at smaller sizes. Of the currently availableablative techniques, radiofrequency ablation and cryoablationhave been the popular ones. We describe our intermediate-termoutcomes with using cryoablation for SRM in patients who werenot ideal candidates for partial nephrectomy.Materials and methods: Nineteen patients treated with cryoablationwere included. Patients with renal lesions <4 cm were consideredfor cryoablation, and all patients were treated between 2002 and2007. Access was either laparoscopic (transperitoneal) or via opensurgical techniques. From 2002 to 2004, the CryoCare System(Endocare, Inc., Irvine, CA) was used, with probe sizes rangingfrom 3 to 5 mm. Before 2004, the SeedNet system (Galil Medical,Arden Hills, MN) was used, with 17-gauge (1.47 mm) IceRod cryoneedles.Recurrence-free survival (RFS) and overall survival (OS)were calculated using Kaplan Meier methodology.Results: The mean age was 56.7 years. The mean tumour size was2.6 cm (range 1.2-4.0 cm). There were no intraoperative or postoperativecomplications in the 19 patients. One patient has beenlost to follow-up; mean follow up was 41.6 months (range 7-84months) in the cohort. Recurrence, defined as either increase insize of lesion or enhancement on follow-up imaging, was seen in4 patients. There was 1 non-cancer specific death, and 1 cancerspecific death.Conclusions: The 4-year RFS rate and OS rate were 83.6% and94.1%, respectively, in patients with SRM who were unsuitablefor partial nephrectomy.Objectif : Le diagnostic étant de plus en plus précoce, on note unintérêt croissant pour les techniques de surveillance et d’ablationdes petites masses rénales. Parmi les techniques actuelles, l’ablationpar radiofréquence et la cryoablation sont les plus utilisées. Nousprésentons ici nos résultats à moyen terme avec la cryoablationde petites masses rénales chez des patients à qui la néphrectomiepartielle ne convenait pas.Matériel et méthodologie : Dix-neuf patients traités par cryoablationont été inclus. Les patients présentant des lésions rénales de < 4 cmétaient considérés, et tous les patients ont été traités entre 2002 et2007. L’abord se faisait par laparoscopie (transpéritonéale) ou parchirurgie ouverte. De 2002 à 2004, on a eu recours au systèmeCryoCare (Endocare, Inc., Irvine, Calif.), avec des sondes de 3 à5 mm. Avant 2004, on utilisait le système SeedNetMC (Galil Medical,Arden Hills, Minn.), avec des cryo-aiguilles IceRod de calibre 17(1,47 mm). Les taux de survie sans récurrence (SSR) et de survieglobale (SG) ont été calculés par la méthode de Kaplan Meier.Résultats : L’âge moyen était de 56,7 ans; la taille moyenne destumeurs était de 2,6 cm (de 1,2 à 4,0 cm). Aucun des 19 patientsn’a présenté de complication intra ou postopératoire. Un patient aété perdu de vue lors du suivi. La durée moyenne du suivi était de41,6 mois (7 à 84 mois). Quatre patients ont présenté une récurrence,définie comme une augmentation de la taille de la lésionou une lésion plus visible lors des épreuves d’imagerie de suivi.Un patient est décédé de causes non liées au cancer, et un autre,des suites du cancer.Conclusions : Les taux de SSR et de SG après 4 ans étaient de83,6 % et de 94,1 %, respectivement, chez des patients avecpetites masses rénales à qui une néphrectomie partielle ne convenaitpas.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".