Table 3.

Clinical outcome and complications of each included studied

	Outcomes		Complications*
Study	Clinical outcome studied	Occurrence (%)	Major complications	Minor complications
Atwell 200833	Technical successa following a single ablation session	97%	Worsening preexisting hypertension (0.90%); pulmonary edema (0.90%); large hematomas requiring angiography and transfusion of red blood cells (2.7%); pulmonary embolus (0.90%)and hematuria requiring ureteral stent placement (090%)
Finley 200834	CSS among patients with biopsy proven RCC during a median follow-up of 11.4 and 13.4 months	100% and 100%	Hemorrhage requiring transfusion (13.5%); blood transfusions (16.2%); internal jugular vein thrombus (2.7%); small bowel injury (2.7%) and loss of kidney (2.7%)
	Treatment failure rateb among patients with biopsy proven RCC during a median follow-up of 11.4 and 13.4 months	5.3% and 4.2%
Georgiades 200835	Technical successc	100%	Silent, small perinephric hematoma; large, painful perinephric hematomas; intercostal nerve injury; genitofemoral nerve injury;
	Overall CRd	97.5%
Hinshaw 200836	Effectiveness ratee for laparoscopic CA	93.3%	Severe respiratory distress (1.1%); intraoperative bowel injury (1.1%) and postoperative atrial fibrillation (1.1%)	Asymptomatic perinephric hematoma; asymptomatic and self-limited urine leak; self-limited flank paresthesia and neuralgia; and intercostal neurapraxia (4.4%).
Lehman 200837	Tumour recurrences	Group 1: 0%	Group 1: no complications (0%)
		Group 2: 4.8%	Group 2 (62%): mortality (4.5%); cerebrovascular accident; myocardial infarction; pulmonary embolism and; hemorrhage with blood transfusion
Nguyen 200838	Tumour recurrences	CA 7.4% RFA 25%	Intraoperative complications: CA: renal arterial injury (21%); RFA: no major intraoperative complications reported on this group (0%)	Intraoperative complications: CA: diaphragmatic injury (7.1%); pleurotomy (requiring chest tube) (7.1%) and peritoneotomy (21%) RFA: no major intraoperative complications reported on this group (0%)
			Postoperative complications: CA: no major postoperative complications reported on this group (0%).	Postoperative complications: CA: urinary leak and anephric state (7.1%).
			RFA: no major postoperative complications reported on this group (0%).	RFA: no major postoperative complications reported on this group (0%).
Weight 200839	Radiographic successf at 6-months follow-up	CA 90% RFA 85%	NR	NR
	Radiographic successf with biopsy and 6-months imaging	CA 89% RFA 81%
Atwell 2007a,b40,41	Technical successg	95%	Large hemorrhage and transient renal failure (necessitated temporary dialysis) (2.5%)
Bandi 200742	Overall, CSSh and RFSi rates	88.5%, 100% and 98.7%, respectively	Atrial fibrillation (1.2%); respiratory failure (1.2%) and; urine leak (1.2%); bleeding (1.2%); bowel injury (1.2%); symptomatic perirenal haematoma (1.2%) and neurophatic pain (1.2%)
Cestari 200743	NR	NR	Minimal intraoperative blood loss (100%); intraoperative renal fracture (2.3%); postoperative anemia (8.1%); transitory hyperpyrexia (6.9%); hematoma (2.3%); pulmonary edema (1.1%); gross hematuria (1.1%) and ureteropelvic junction obstruction (1.1%)
Littrup 200744	Technical successj	98%	Perinephric hematoma; hematuria and ureteral stricture. Major and minor complications were seen in 6% and 22% procedures, respectively
Lokken 200730	Occurrence of applicator track nodules	CA 2.7%	CA: small perinephric hematoma (0.3%)
		RFA 1.7%	RFA: self-limited hematuria and small perinephric hematoma (0.3%)
Weld 200745	3-year CSS rate	100%	Hemorrhage (3.2%); urinary leak (3.2%); gross hematuria (3.2%); ileus (3.2%); perinephric urinoma (3.2%); hydronephrosis (3.2%); blood clots (3.2%); atrial fibrillation (3.2%); and heart failure (3.2%)
	Mean increase of ablation zone size on follow-up CT or MRI at 3 months.	14
	Mean decrease of ablation zone size on follow-up CT or MRI at 3 months	71
Wright 200729	Treatment failuresk	6%	No major and minor complications were found (0%)
Davol 200646	Complete radiologic resolutionl from a total of 40 patients available in the analysis	85%	There were no major adverse events found (0%)	There were 7 minor adverse events (14.5%)
	Treatment failurem from a total of 40 patients available in the analysis	12.5%
	CSS rate in a total of 32 patients	100%
	CSS rate after a single CA procedure in a total of 32 patients	84.3%
Hegarty 200647	Radiologic evidence of tumour recurrence or persistence of disease;	CA 1.8%	CA: congestive heart failure (0.62%); myocardial infarct (0.62%); required thoracotomy for hemothorax (0.62%).	CA: required temporary ureteral stent insertion (1.2%)
		RFA 11.1%
	CSS	CA 98% at a median 3-year follow-up	RFA: no major complications were reported in the RFA group (0%).	RFA: NR
		RFA 100% at 1-year median follow-up
Lawatsch 200648	Overall tumour recurrence rate per patient	5.9% in 34 patients	Intraoperative complications: open surgery conversion (3.3%); nephrectomy for bleeding (1.6%); myocardial infarction (1.6%); pneumothorax (3,3%)
	Recurrence rate per lesion treated in patients with biopsy confirmed RCC	5.1% for 38 lesions	Postoperative complications: perinephric hematoma (1.6%); pulmonary embolus (1.6%) and ileus (3.3%)
Matin 200649	Overall survival rate in all patients from both groups	82.5%	NR	NR
	2-year metastasis-free survival rate in all patients from both groups	97.4%
Schwartz 200650	No growth or evidence of recurrence on CT scan or MRI at 3 months	98.18%	Renal fracture (1.2%); stroke (1.2%) and hydronephrosis (1.2%)
	Radiographic enhancement after the procedure	3.6%
Desai 200551	Local recurrence at a mean follow-up time of 5.8 months in LPN group and 24.6 months in CA group	LPN 0.6%	LPN associated with greater blood loss and a higher incidence of delayed complications after hospital discharge compared with CA 16.3% versus 2.2%, respectively
		CA 3%
Gill 200527	3-year CSS (in a total of 51 patients with sporadicunilateral renal tumour)	98%	NR	NR
Cestari 200452	Mean reduction of cryolesions on MRI 12 and 18 months of follow-up	73% and 76% (in a total number of patients 32 and 30, respectively)	Transitory hyperthermia (8.1%); hematoma (8.1%); gross hematuria (2.7%); low postoperative pain (100%); and ureteropelvic junction obstruction (2.7%)
Gill 200053	Follow-up CT-directed needle negative biopsies at 3 to 6 months in a total of 23 patients	100%	Perirenal hematoma (3.1%) and herpes esophagitis (3.1%)

CSS: cancer-specific survival; RCC: renal cell carcinoma; CR: complete response; CA: cryoablation; RFA: radiofrequency ablation; RFS: recurrence-free survival; CT: computed tomography; MRI: magnetic resonance imaging.

^*Percentages were calculated on a patient number basis;

^aExtension of the ice ball beyond the tumour margin and post-ablation images showing no contrast enhancement in the tumour parenchyma;

^bNot defined;

^cCompletion of the cycle of a 10-minute freeze, 8-minute active thaw, and 10-minute repeat freeze with the ice ball covering the entire lesion and extending at least 5 mm beyond its border;

^dComplete lack of enhancement of a previously enhancing mass;

^eComplete ablation of macroscopic tumour as shown at imaging follow-up;

^fNo evidence of central or nodular enhancement after treatment;

^gExtension of the ice ball beyond the tumour margin and postablation imaging findings of no contrast enhancement in the area encompassing the original tumour;

^hAbsence of death from renal cancer;

ⁱNo evidence of radiographic recurrence at the site of CA, regardless of the lesion pathology;

^jNot defined;

^kContinued contrast enhancement on postoperative CT;

^lAn involuted scar or fibrosis without evidence of growth or enhancement on the most recently available imaging study;

^mGrowth of a persistent renal mass, as well as the persistence or development of heterogeneous peripheral enhancement within any persistent mass.