Applications

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

Find out about the service or technology in this application and the medical condition it addresses. You can also view the application documents, the deadlines for providing consultation input and the outcome of the application when the MSAC process is complete.

  • Status Complete
  • Type New application
  • Pre-PASC consultation -
  • Pre-MSAC consultation -
  • Outcome Supported

Application details

Reason for application

New MBS item.

Service or technology in this application

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.

Type: Therapeutic

Medical condition this application addresses

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).

Meetings to consider this application

  • PASC meeting: 5 to 6 December 2019
  • ESC meeting: 8 to 9 October 2020
  • MSAC meeting: 26 to 27 November 2020