1597 - Cryoablation for biopsy-confirmed renal cell carcinoma (RCC) ≤4cm in patients not suitable for partial nephrectomy

Page last updated: 15 February 2021

Application Detail

Description of Medical Service

Cryoablation (also known as cryotherapy or cryosurgery) is a well-established technology for the treatment of many benign and malignant tumours and lesions. Cryoablation destroys tissue by freezing the cancer cells. Very precise targeting and control of the extremely cold energy allow for efficient destruction of tumor cells while leaving healthy kidney tissue intact and functional.

To freeze the cancer, special ultra-thin probes called cryoablation needles are inserted into the site targeted for ablation. Argon gas is delivered under pressure into a small chamber inside the tip of the needle where it expands and cools, reaching a temperature well below -100º Celsius. This produces an iceball of predictable size and shape around the needle. This iceball engulfs the tumor, killing the cancerous cells as well as a small margin of surrounding tissue while sparing healthy kidney structures. A number of approaches can be used to perform renal cancer cryoablation, so the physician can customise the treatment to accommodate the patient’s general health as well as the size and location of the tumor. A minimally invasive approach (either percutaneous or laparoscopic), rather than an open surgical approach, is usually preferred.

Description of Medical Condition

Small masses in the kidney are considered to be cancerous until proven otherwise. Renal cell carcinoma (RCC; cancer that starts in cells that line the tubules of the kidney) is the most common type of kidney cancer. Risk factors for developing RCC include older age (> 64 years), gender (twice as common in men), obesity, high blood pressure, and smoking. Due to the increased use of cross-sectional imaging, a growing number of renal tumours are incidentally discovered at earlier stages which increases the chance of treatment success. Renal cancer is stratified into 4 stages (I-IV). Stage I is defined as tumor size up to 7 centimetres in diameter, that is confined to the kidney. Tumours measuring ≤ 4 cm are considered small renal masses (Stage 1a).

Reason for Application

New MBS item

Medical Service Type

Therapeutic

Previous Application Number/s

Not Applicable

Associated Documentation

Application Form

Application Form (PDF 1385 KB)
Application Form (Word 506 KB)

Consultation Survey

Consultation Survey (PDF 486 KB)
Consultation Survey (Word 70 KB)

PICO Confirmation

PICO Confirmation (PDF 2045 KB)
PICO Confirmation (Word 354 KB)

Assessment Report

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Public Summary Document

Public Summary Document (PDF 811 KB)
Public Summary Document (Word 278 KB)

Meetings for this Application

PASC

5-6 December 2019

ESC

8-9 October 2020

MSAC

26-27 November 2020