Indications and contraindications for cryoablation of renal cancer

The traditional treatment for renal cancer is radical nephrectomy, but because this treatment method is highly invasive, it is not suitable for patients with bilateral renal cancer, solitary renal cancer, and the elderly and frail. With the advancement of cryoablation technology and the development of image-guided systems, the clinical use of cryoablation to treat primary small renal cancer has been widely promoted and has achieved satisfactory results.

The indications for cryoablation of renal cancer may include absolute indications, relative indications, and selective indications.

Absolute indications

Cryoablation can be used as an option for patients who have become kidneyless after radical nephrectomy, such as patients with solitary kidney (patients who have undergone unilateral radical nephrectomy and now have metastases on the contralateral side) and patients with bilateral multiple renal tumors.

Relative indications

Patients with unilateral renal tumors who cannot tolerate surgery due to local or systemic factors or who may suffer from renal dysfunction after surgery, such as patients with kidney stones, chronic pyelonephritis, diabetes, patients with a familial tendency to multiple renal tumors syndrome (Von Hippel-Lindau syndrome), and elderly and frail patients who are unable to undergo surgery.

Selective Indications

Patients with small renal cancer with a diameter of ≤4 cm and a normal contralateral kidney. Currently, most surgeons limit its application to patients with exophytic, solid, small tumors (tumor diameter <4 cm).