Clinical Evidence Supporting Cryoablation in RCC: The EuRECA Registry
A joint mission between Urologists and Interventional Radiologists
Largest real-world, prospective, multicenter, multidisciplinary study
on the use of cryoablation for treatment of RCC in 1700+ patients1
RCC patients,
1400+ biopsy-confirmed
sites across
5 European countries
disease-free recurrence,
overall survival, and more
The EuRECA registry demonstrates cryoablation is a safe and effective RCC treatment with durable long-term oncologic outcomes.
Primary technical efficacy2
97.9%
T1a tumours
94.1%
T1b tumours
3.4%
Low major complication rate3
96.3%
Local recurrence-free survival (interim results, median follow-up: 4.8 years)4
Renal function preserved, including in patients with solitary kidney5,6
Cryoablation is a safe and effective treatment for patients with RCC2,3
Of 1,207 patients with T1a RCC, cryoablation showed an overall primary technical efficacy (PTE) of 97.9%2
- The most significant risk factor for residual untreated tumour (RUT) is central renal vessel contact
- T1b PTE: 94.1%
Cryoablation demonstrated a low major complication rate of 3.4%3
- 713 renal tumours treated with cryoablation across 647 sessions, with 54 total complications
- Bleeding was the most common complication (3.2%), with 9 cases (1.4%) requiring subsequent treatment
- tumours >4 cm were the only significant predictor of major complications
Major complication rates
p < 0.05, statistical significance
Major complication rate for this study is defined as Clavien Dindo grade ≥ 3
Cryoablation preserved renal function while minimizing the risk of progression to chronic kidney disease or the need for dialysis in patients with a solitary kidney and RCC5,6
In two studies – one using laparoscopy-assisted (LARC) and the other percutaneous cryoablation – all patients had solitary kidneys, yet none required dialysis, and no patients with chronic kidney disease advanced to severe or end-stage (IV or V).
- 72 patients underwent LARC and 70 patients underwent percutaneous cryoablation
- LARC treatments resulted in eGFR reduction of 6.8%
- Percutaneous cryoablation treatments resulted in eGFR reduction of 11.1%
Cryoablation demonstrated durable long-term oncologic outcomes4
Long-term interim results in 922 RCC T1a patients (mean tumour size 2.7 cm; median follow-up 4.8 years) showed 96.3% local recurrence-free survival and 85.6% overall survival.
*Interim results presented at ECIO 2026
References
1.EuRECA Cryotherapy Registry, https://www.eureca-registry.com/Public/Home.aspx
2.King, A. J., Steenkamp, R., Graumann, O., Wah, T. M., Alcorn, D., Nielsen, T. K., de Kerviler, E., Zondervan, P. J., Walkden, M., Lagerveld, B., Van Strijen, M., Keeley Jr., F. X., & Breen, D. J. (2025). Risk Factors for Residual Unablated Tumour Following CT-Guided Percutaneous Renal Cryoablation: Lessons from the EuRECA Registry. CardioVascular and Interventional Radiology, 48(2), 196-204. Article 802437. https://doi.org/10.1007/s00270-024-03951-2
3.Garnon, J., Van Strijen, M. J., Nielsen, T. K., King, A. J., Montauban Van Swijndregt, A. D., Cazzato, R. L., Auloge, P., Rousseau, C., Dalili, D., Keeley, F. X., Jr, Lagerveld, B. W., & Breen, D. J. (2019). Safety of percutaneous renal cryoablation: an international multicentre experience from the EuRECA retrospective percutaneous database. European radiology, 29(11), 6293–6299. https://doi.org/10.1007/s00330-019-06191-y
4.Graumann, Ole (2026, April 27). Percutaneous ablation of T1a: standard of care? [Conference presentation]. CF 222 – Defining success in renal IO: outcomes that drive practice [Symposium]. ECIO Congress 2025, Basel, Switzerland
5.Pietersen, P. I., Stougaard, S., Keeley, F. X., Jr, Lagerveld, B., Breen, D., King, A., Nielsen, T. K., van Strijen, M., Garnon, J., Alcorn, D., de Kerviler, E., Zondervan, P., Wah, T. M., Junker, T., & Graumann, O. (2024). Renal Function After CT-Guided Cryoablation of Small Renal Tumours in Patients with Solitary Kidney: An Analysis of European Multinational Prospective EuRECA Registry. Cardiovascular and interventional radiology, 47(5), 583–589. https://doi.org/10.1007/s00270-023-03634-4
6.Sriprasad, S., Aldiwani, M., Pandian, S., Nielsen, T. K., Ismail, M., Barber, N. J., Lughezzani, G., Larcher, A., Lagerveld, B. W., & Keeley, F. X., Jr (2020). Renal Function Loss After Cryoablation of Small Renal Masses in Solitary Kidneys: European Registry for Renal Cryoablation Multi-Institutional Study. Journal of endourology, 34(2), 233–239. https://doi.org/10.1089/end.2019.0669
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