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EuRECA study

Cryoablation is a safe and effective treatment for patients with RCC1,2

Of 1,207 patients with T1a RCC, cryoablation showed an overall primary technical efficacy (PTE) of 97.9%.
  • The most significant risk factor for residual untreated tumor (RUT) is central renal vessel contact
  • T1b PTE noted as 94.1% and T1a PTE noted as 97.9%

Table 1 Demographic data and descriptive statistics

 

Patient and tumor characteristicsRUT %PTE %RUT NumberPTE Numberp-value
Age  Avg 67.6 yrsAvg 66.3 yrs 
Sex63.2% male66.8% male   
Mean tumor size35 mm29 mm  0.0017
Clinical size group    0.0025
     0–4 cm2.197.9261207 
     > 4.1–7 cm5.994.111176 
Exophytic rate    0.4007
     < 50%2.797.316577 
     >50%2.197.912552 
     Completely endophytic3.896.310257 
Hilar suffix?     <0.001
     No1.998.1251271 
     Yes, if tumor touches renal artery or vein10.289.813115 

Cryoablation of T1 RCC resulted in low complication rates

  • A total of 713 renal tumors underwent cryoablation in 647 individual sessions. 54 total complications occurred in the 647 sessions
  • The most frequent complication was bleeding (3.2%), with 9 cases (1.4% requiring subsequent treatment)
  • Tumor size >4 cm was the only significant predictive factor for major complication

Major complication rates*

2.3 %

Tumor size ≤4 cm ​
(14/609)​

7.7 %

Tumor size ≥4 cm ​
(8/104)​


Cryoablation preserved renal function without the need for dialysis or progression in chronic kidney disease in patients with solitary kidney and RCC.3,4

In 2 studies (one laparoscopy-assisted (LARC)4 and the other percutaneous cryoablation3) with patients with solitary kidneys, no patients required subsequent dialysis, and no patients advanced their chronic kidney disease 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%​

Estimated glomerular filtration (eGFR) rates at baseline and follow-up​

 

 Baseline3 monthsMean difference (95% CI)p-value
eGFR in mL/min/1.73 m2, mean [SD]a Chronic kidney disease stage, n (%)b55.8 [16.8]49.6 [16.5]- 6.2 (- 8.2; - 4.2)0.001*
I2 (2.9)1 (1.4) 0.001*
II25 (35.7)16 (22.9)                         
IIIa26 (37.1)19 (27.1)  
IIIb14 (20.0)30 (42.9)  
IV2 (2.9)3 (4.3)  
V1 (1.4)1 (1.4)  

aPaired t-test for the mean difference between baseline and 3-month eGFR. Normality assessed via visualizations​ of the data and Shapiro-Wilk W test for normality​

bWilcoxon signed-rank test for equality between eGFR groups at baseline and 3 months​

*p < 0.05 , statistical significance


  1. 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
  2. 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
  3.  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
  4. 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

* Major complication rate for this study is defined as Clavien Dindo grade ≥ 3