BlueCross BlueShield of Tennessee Medical Policy Manual

Cryosurgical Ablation for Treatment of Renal Tumors


Cryosurgical ablation (cryoablation or cryosurgery) involves exposing tissues to extreme cold in order to produce well-demarcated areas of cell injury and destruction. The tissue is cooled below -20 degrees C. The cold is usually produced by use of a probe containing liquid nitrogen. Cryosurgical ablation may be performed as an open surgical technique, percutaneously, or laparoscopically with ultrasound, magnetic resonance imaging (MRI), or computed tomography (CT) guidance.


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American Urological Association. (2013). Follow-up for clinically localized renal neoplasms: AUA guideline. Retrieved November 30, 2015 from: (NGC#009917)

Bhindi, B., Thompson, R., Mason, R., Haddad, M., Geske, J., Kurup, A., (2017, June) Comprehensive assessment of renal tumour complexity in a large percutaneous cryoablation cohort. BJU International, 119 (6), 905-912. Abstract retrieved September 26, 2017 from PubMed database.

BlueCross BlueShield Association. Medical Policy Reference Manual. (8:2016). Cryosurgical ablation of miscellaneous solid tumors other than liver, prostate, or dermatologic tumors (7.01.92). Retrieved September 26, 2017 from BlueWeb. (49 articles and/or guidelines reviewed)

Chen, J. X., Guzzo, T. J., Malkowicz, S. B., Soulen, M. C., Wein, A. J., Clark, T. W., et al. (2016). Complication and readmission rates following same-day discharge after percutaneous renal tumor ablation. Journal of Vascular Interventional Radiology, 27 (1), 80-86. Abstract retrieved November 9, 2016 from PubMed database.

Kim, D., Wood, C., & Karam, J. (2014). Treating the two extremes in renal cell carcinoma: management of small renal masses and cytoreductive nephrectomy in metastatic disease. Retrieved November 30, 2015 from 

Martin, J., & Athreya, S. (2013). Meta-analysis of cryoablation versus microwave ablation for small renal masses: is there a difference in outcome? Diagnostic Interventional Radiology, 19, 501-501. (Level 4 evidence - Independent)

Moynagh, M. R., Schmit, G. D., Thompson, R. H., Boorjian, S. A., Woodrum, D. A., Curry, T. B., et al. (2015). Percutaneous cryoablation of clinical T2 (> 7 cm) renal masses: technical considerations, complications, and short-term outcomes. Journal of Vascular Interventional Radiology, 26 (6), 800-806. Abstract retrieved November 9, 2016 from PubMed database.

National Comprehensive Cancer Network. (2017, September). NCCN clinical practice guidelines in oncology (NCCN Guidelines®) Kidney cancer. (V.1.2018). Retrieved September 26, 2017 from the National Comprehensive Cancer Network.

Rodriguez, F. O., Akdogan, B., Marszalek, M., Langenhuijsen, J. F., Brookman-May, S. Stewart, G. D. (2016). Current status of focal cryoablation for small renal masses. Urology, 90, 9-15. Abstract retrieved November 9, 2016 from PubMed database.

U. S. Food and Drug Administration. (2003, August). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K032333 (Cryocare™). Retrieved November 30, 2015 from:

U. S. Food and Drug Administration. (2003, May). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K031117 (SeedNet™). Retrieved November 30, 2015 from   

Winifred S. Hayes, Inc. Medical Technology Directory. (2014, June; last update search May 2017) Percutaneous cryoablation for the treatment of renal masses. Retrieved November 9, 2016 from  (58 articles and/or guidelines reviewed)

Yan, X., Zhang, M., Chen, X., Wei, W., Yang, R., Yang, Y., et al. (2015). Image-guided percutaneous renal cryoablation for stage 1 renal cell carcinoma with high surgical risk. World Journal of Surgical Oncology, 13, 200. (Level 2 evidence - Independent)

Zargar, H., Samarasekera, D., Khalifeh, A., Remer, E. M., O’Malley, C., Akca, O. (2015). Laparoscopic vs percutaneous cryoablation for the small renal mass: 15-year experience at a single center. Urology, 85 (4), 850-855. Abstract retrieved November 9, 2016 from PubMed database.




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