Long-Term Outcomes of Cryoablation for Solitary De Novo T1a Renal Cell Carcinoma: A Tertiary Cancer Center Experience

Objective: To assess the long-term oncologic and survival outcomes of percutaneous cryoablation (PCA) for patients with solitary de novo T1a renal cell carcinoma (RCC). Methods: This retrospective study was conducted following the STROBE guidelines. We included patients with a single, biopsy-confirmed, treatment-naïve T1a RCC (<4 cm) who underwent PCA between January 2008 and December 2021. Patient demographics, tumor characteristics, and procedural details were collected. Survival analyses were performed using the Kaplan–Meier estimator. Results: Eighty-six patients (57 men and 29 women) with a median age of 69 years met the inclusion criteria. Fifty patients (58%) had a history of an additional non-renal malignancy. In total, 86 renal tumors were treated using PCA, with a median tumor diameter of 2.7 cm. Clear cell RCC accounted for 67.4% of the tumors. Procedural complications classified as Clavien–Dindo grade III or higher occurred in 4.6% of cases. Local tumor recurrence at the ablation site was observed in five patients (5.8%), and four patients (4.6%) developed new lesions elsewhere within the kidney. The estimated median overall survival was 10.34 years. The 10-year local recurrence-free and disease-free survival rates were 93.5% and 84.0%, respectively. Both metastasis-free survival and cancer-specific survival rates at 10 years were 100%. Conclusions: Percutaneous cryoablation provided durable local tumor control with low major morbidity and favorable long-term oncologic outcomes in this selected cohort of patients with solitary cT1a renal tumors.