Post-ablation syndrome after percutaneous cryoablation of small renal tumors: A prospective study of incidence, severity, duration, and effect on lifestyle

Takahiro Kawabata, Takao Hiraki, Toshihiro Iguchi, Yusuke Matsui, Mayu Uka, Yoshihisa Masaoka, Toshiyuki Komaki, Jun Sakurai, Hideo Gobara, Motoo Araki, Yasutomo Nasu, Susumu Kanazawa

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Abstract

Purpose: To prospectively investigate the incidence, severity, duration, and effect on lifestyle of post-ablation syndrome (PAS) after percutaneous renal cryoablation. Materials and Methods: We enrolled 39 patients (27 male and 12 female; mean age, 62 years) who underwent 40 CT-guided cryoablation sessions for pathologically proven renal cancer (mean size, 20 mm) between December 2015 and December 2017. Four symptoms attributable to PAS, i.e., fever, nausea, vomiting, malaise, and the synergistic effect of these symptoms on lifestyle by 21 days after ablation were evaluated using a questionnaire. Symptoms were graded according to the common toxicity criteria of adverse events. Results: The incidences of fever, nausea, vomiting, and malaise were 100% (40/40), 20% (8/40), 20% (8/40), and 63% (25/40), respectively. Most (78/81, 96%) symptoms had begun by day 2. The highest grade of fever per session was 0 (defined as ≥37.0 °C and <38.0 °C) (n = 24), 1 (n = 15), or 2 (n = 1); that of nausea was 2 (n = 8); that of vomiting was 1 (n = 7) or 3 (n = 1); and that of malaise was 1 (n = 14) or 2 (n = 11). Most (76/81, 94%) symptoms had resolved by day 8. The average values for the maximum scores of interference with general activity and work were 3.6 and 1.1, respectively. Conclusion: All symptoms were generally early-onset and self-limiting, with minimal impact on lifestyle and resolution by day 8. The clinical course and impact of PAS should be acknowledged by practitioners who manage patients undergoing renal cryoablation.

Original languageEnglish
Article number108750
JournalEuropean Journal of Radiology
Volume122
DOIs
Publication statusPublished - Jan 2020

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Cryosurgery
Nausea
Vomiting
Life Style
Fever
Prospective Studies
Kidney
Incidence
Neoplasms
Kidney Neoplasms

Keywords

  • Cryoablation
  • CT-guided
  • Post-ablation syndrome
  • Renal cancer

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{70826f5384364ef9bd62536fa6254246,
title = "Post-ablation syndrome after percutaneous cryoablation of small renal tumors: A prospective study of incidence, severity, duration, and effect on lifestyle",
abstract = "Purpose: To prospectively investigate the incidence, severity, duration, and effect on lifestyle of post-ablation syndrome (PAS) after percutaneous renal cryoablation. Materials and Methods: We enrolled 39 patients (27 male and 12 female; mean age, 62 years) who underwent 40 CT-guided cryoablation sessions for pathologically proven renal cancer (mean size, 20 mm) between December 2015 and December 2017. Four symptoms attributable to PAS, i.e., fever, nausea, vomiting, malaise, and the synergistic effect of these symptoms on lifestyle by 21 days after ablation were evaluated using a questionnaire. Symptoms were graded according to the common toxicity criteria of adverse events. Results: The incidences of fever, nausea, vomiting, and malaise were 100{\%} (40/40), 20{\%} (8/40), 20{\%} (8/40), and 63{\%} (25/40), respectively. Most (78/81, 96{\%}) symptoms had begun by day 2. The highest grade of fever per session was 0 (defined as ≥37.0 °C and <38.0 °C) (n = 24), 1 (n = 15), or 2 (n = 1); that of nausea was 2 (n = 8); that of vomiting was 1 (n = 7) or 3 (n = 1); and that of malaise was 1 (n = 14) or 2 (n = 11). Most (76/81, 94{\%}) symptoms had resolved by day 8. The average values for the maximum scores of interference with general activity and work were 3.6 and 1.1, respectively. Conclusion: All symptoms were generally early-onset and self-limiting, with minimal impact on lifestyle and resolution by day 8. The clinical course and impact of PAS should be acknowledged by practitioners who manage patients undergoing renal cryoablation.",
keywords = "Cryoablation, CT-guided, Post-ablation syndrome, Renal cancer",
author = "Takahiro Kawabata and Takao Hiraki and Toshihiro Iguchi and Yusuke Matsui and Mayu Uka and Yoshihisa Masaoka and Toshiyuki Komaki and Jun Sakurai and Hideo Gobara and Motoo Araki and Yasutomo Nasu and Susumu Kanazawa",
year = "2020",
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doi = "10.1016/j.ejrad.2019.108750",
language = "English",
volume = "122",
journal = "European Journal of Radiology",
issn = "0720-048X",
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TY - JOUR

T1 - Post-ablation syndrome after percutaneous cryoablation of small renal tumors

T2 - A prospective study of incidence, severity, duration, and effect on lifestyle

AU - Kawabata, Takahiro

AU - Hiraki, Takao

AU - Iguchi, Toshihiro

AU - Matsui, Yusuke

AU - Uka, Mayu

AU - Masaoka, Yoshihisa

AU - Komaki, Toshiyuki

AU - Sakurai, Jun

AU - Gobara, Hideo

AU - Araki, Motoo

AU - Nasu, Yasutomo

AU - Kanazawa, Susumu

PY - 2020/1

Y1 - 2020/1

N2 - Purpose: To prospectively investigate the incidence, severity, duration, and effect on lifestyle of post-ablation syndrome (PAS) after percutaneous renal cryoablation. Materials and Methods: We enrolled 39 patients (27 male and 12 female; mean age, 62 years) who underwent 40 CT-guided cryoablation sessions for pathologically proven renal cancer (mean size, 20 mm) between December 2015 and December 2017. Four symptoms attributable to PAS, i.e., fever, nausea, vomiting, malaise, and the synergistic effect of these symptoms on lifestyle by 21 days after ablation were evaluated using a questionnaire. Symptoms were graded according to the common toxicity criteria of adverse events. Results: The incidences of fever, nausea, vomiting, and malaise were 100% (40/40), 20% (8/40), 20% (8/40), and 63% (25/40), respectively. Most (78/81, 96%) symptoms had begun by day 2. The highest grade of fever per session was 0 (defined as ≥37.0 °C and <38.0 °C) (n = 24), 1 (n = 15), or 2 (n = 1); that of nausea was 2 (n = 8); that of vomiting was 1 (n = 7) or 3 (n = 1); and that of malaise was 1 (n = 14) or 2 (n = 11). Most (76/81, 94%) symptoms had resolved by day 8. The average values for the maximum scores of interference with general activity and work were 3.6 and 1.1, respectively. Conclusion: All symptoms were generally early-onset and self-limiting, with minimal impact on lifestyle and resolution by day 8. The clinical course and impact of PAS should be acknowledged by practitioners who manage patients undergoing renal cryoablation.

AB - Purpose: To prospectively investigate the incidence, severity, duration, and effect on lifestyle of post-ablation syndrome (PAS) after percutaneous renal cryoablation. Materials and Methods: We enrolled 39 patients (27 male and 12 female; mean age, 62 years) who underwent 40 CT-guided cryoablation sessions for pathologically proven renal cancer (mean size, 20 mm) between December 2015 and December 2017. Four symptoms attributable to PAS, i.e., fever, nausea, vomiting, malaise, and the synergistic effect of these symptoms on lifestyle by 21 days after ablation were evaluated using a questionnaire. Symptoms were graded according to the common toxicity criteria of adverse events. Results: The incidences of fever, nausea, vomiting, and malaise were 100% (40/40), 20% (8/40), 20% (8/40), and 63% (25/40), respectively. Most (78/81, 96%) symptoms had begun by day 2. The highest grade of fever per session was 0 (defined as ≥37.0 °C and <38.0 °C) (n = 24), 1 (n = 15), or 2 (n = 1); that of nausea was 2 (n = 8); that of vomiting was 1 (n = 7) or 3 (n = 1); and that of malaise was 1 (n = 14) or 2 (n = 11). Most (76/81, 94%) symptoms had resolved by day 8. The average values for the maximum scores of interference with general activity and work were 3.6 and 1.1, respectively. Conclusion: All symptoms were generally early-onset and self-limiting, with minimal impact on lifestyle and resolution by day 8. The clinical course and impact of PAS should be acknowledged by practitioners who manage patients undergoing renal cryoablation.

KW - Cryoablation

KW - CT-guided

KW - Post-ablation syndrome

KW - Renal cancer

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