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Deivasigamani et al. Mini-invasive Surg 2023;7:9 https://dx.doi.org/10.20517/2574-1225.2022.99 Page 15 of 19

Nanoparticles
There has been increasing interest in the use of nanoparticles for the treatment of cancer, and there are
[8]
future potential applications of various types of nanoparticles to make cryoablation more effective .
Depending on the nanomaterial used, nanomaterials have the potential for use in the setting of cryotherapy
for enhanced image guidance, enhancing target tissue death from cryoablation, minimizing systemic drug
[8]
toxicity, and/or minimizing cryoinjury to adjacent healthy tissue . These technologies are still in the early
phases of development but represent exciting areas of potential further advancement of the safety and
efficacy of cryoablation techniques.

Conclusion
CA is a safe and effective alternative treatment for select patients with SRMs, as well as in select cases of
recurrence after primary treatment and select patients with metastatic RCC. Previously CA was considered
primarily for patients with increased age and comorbidities that put them at increased risk for PN.
However, given increasing evidence of safety and efficacy as well as increased availability of PCA, younger
and healthier patients may also benefit from CA after receiving full risk and benefits counseling. The key
benefits of CA include shorter hospital stays, lower morbidity, and minimal changes in postoperative renal
function. Patients should be counseled on the potential risks associated with CA, including the potential
need for repeat CA if there is incomplete ablation or local recurrence. Patients should be actively monitored
for recurrence using serial imaging based on their risk of recurrence owing to tumor characteristics and
pathology.

There have been significant advances in accessible data regarding safety, and outcomes following CA for
SRM, especially in long-term follow-up; however, further research is still needed to fully define the utility of
cryoablation in SRM management because there is little reliability in making the comparison between
treatment methods based on the current level of evidence. It can be anticipated that the safety and efficacy
of CA will continue to improve with continued developments in imaging, utilized instruments, related
technologies, and combined treatment methods. Thus, in addition to further study on current outcomes
following CA, there is a need for continued re-assessment of CA outcomes as the technologies and
techniques used continue to improve.

DECLARATIONS
Authors’ contributions
Substantial contribution to conception or design of the work, acquisition, drafting and interpretation of data
for the work: Deivasigamani S
Substantial contribution to the drafting and interpretation of data for the work: Adams ES
Substantial contribution to the drafting and interpretation of data for the work: Seguier D
Substantial contribution to the drafting and interpretation of data for the work: Kotamarti S
Revising the work critically for important intellectual content and final approval of the version to be
published: Polascik TJ

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.