Incidence of Post-ablation Syndrome Following Image-Guided Percutaneous Cryoablation of Renal Cell Carcinoma: A Prospective Study

Cardiovasc Intervent Radiol. 2018 Feb;41(2):270-276. doi: 10.1007/s00270-017-1811-1. Epub 2017 Nov 28.

Abstract

Purpose: To prospectively evaluate the incidence of post-ablation syndrome (fever and flu-like symptoms) and impact on the quality of life in the first 10 days following percutaneous image-guided cryoablation for renal cell carcinoma (RCC).

Materials and methods: A prospective study of all cryoablation procedures with biopsy proven RCC was conducted with institutional review board approval between 08/2012 and 04/2016. Sixty-four patients (43 males and 21 females) underwent cryoablation. Mean age was 68 (range 24-86). A telephone questionnaire survey was conducted on days 1, 3, 5, 7 and 10 following cryoablation, and complications were recorded. Data collected included temperature, degree of flu-like symptoms, severity of pain, percentage of pain relief with analgesics, interference with general activity and with work (graded on a 0-10 Numeric Intensity Scale).

Results: Following cryoablation, six patients (9%) out of 64 developed post-ablation syndrome. Thirty-three patients (52%) developed flu-like symptoms only, which completely resolved by day 10 in 25 patients (39%). One patient had pyrexia only, which was self- limiting by day 10. Twenty-four patients (38%) were asymptomatic. Pain (mean score = 2.1) and interference on general activities (mean score = 1.8) and work (mean score = 2) following cryoablation peaked on day 3 and improved subsequently. Forty-six patients (72%) had 90-100% pain relief by day 10. No major complications were observed.

Conclusion: The full spectrum of post-ablation syndrome following cryoablation occurs in approximately 9% of patients; however, 61% of patients experience flu-like symptoms in the first 10 days, which are self-limiting.

Keywords: Cryoablation; Post-ablation syndrome; Radiofrequency ablation; Renal cell cancer.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Carcinoma, Renal Cell / pathology
  • Carcinoma, Renal Cell / surgery*
  • Catheter Ablation*
  • Cryosurgery
  • Female
  • Fever / epidemiology*
  • Fever / etiology
  • Humans
  • Incidence
  • Influenza, Human / epidemiology*
  • Influenza, Human / etiology
  • Kidney Neoplasms / pathology
  • Kidney Neoplasms / surgery*
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Prospective Studies
  • Quality of Life
  • Surgery, Computer-Assisted*
  • Syndrome