PHYSICIAN
INFO
Contraindications for
Kidney Cancer Cryotherapy
During the process of determining
the best treatment plan for a patient, there are
many variables that physicians must consider.
Along with the patient’s age and general health,
tumor size, location, and disease progression
are also carefully considered. As the database
of cryosurgical treatment experience has grown,
certain circumstances have been identified that
may make cryoablation a less than optimal kidney
cancer treatment for a particular patient.
These conditions are called contraindications,
and when they are present, they may make it inadvisable
to perform a minimally invasive procedure such
as renal cryosurgery, radiofrequency ablation
(RFA) or other thermal ablation.
These conditions include:
• A central or hilar mass – Tumors that are near the center of the kidney, or that surround the area where blood vessels enter and leave the kidney.
• Tumors abutting the renal pelvis – Tumors sitting close to the collection system and upper ureter.
• Tumors greater than 4cm – Although there is evidence that, unlike RFA, cryosurgical ablation may be an appropriate treatment for larger tumors, tumors larger than 4cm may be associated with a greater incidence of advanced or metastatic disease.
• Metastatic disease – Except in cases of palliative treatment, ablation treatment is usually not performed when known metastases exist.
• Patients who are receiving anticoagulation therapy and are unable to stop treatment.
However, even when one or more of
these conditions are present, the surgeon may
still decide that cryosurgery to remove the kidney
tumor is the best approach. In this case, the
physician has considered all of the risk factors
present and weighed them against the benefits
of renal
cancer ablation. For example, if a patient
has decreased renal function, a single kidney,
or suffers from certain familial syndromes that
affect the kidneys, the physician may decide that
cryotherapy ablation will result in the highest
quality of life post-surgically. In cases of advanced
disease, kidney
cancer ablation may be performed as a palliative
procedure to alleviate kidney pain and make the
patient more comfortable.
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