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Erschienen in:
01.07.2013 | Interventional
Ten-year experience of percutaneous image-guided radiofrequency ablation of malignant renal tumours in high-risk patients
Erschienen in: European Radiology | Ausgabe 7/2013
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Objectives
To evaluate survival and outcomes after percutaneous radiofrequency ablation (RFA) of malignant renal tumours in high-risk patients with long-term follow-up.
Methods
Between 2002 and 2009, 62 patients (71 tumours), with a median age of 73.5 years (20–87), consecutively treated with RFA under ultrasound or computed tomography guidance for malignant renal tumours were retrospectively selected and prospectively followed until 2012, including 25 patients (40.3 %) with solitary kidney and 7 cystic cancers. Maximal tumour diameters were between 8 and 46 mm (median: 23 mm).
Results
Radiofrequency ablation was technically possible for all patients. Mean follow-up was 38.8 months (range: 18–78 months). Primary and secondary technique effectiveness was 95.2 % and 98.4 % per patient respectively. The rates of local tumour progression and metastatic evolution were 3.2 % and 9.7 % per patient and were associated with tumour size >4 cm (P = 0.005). The disease-free survival rates were 88.3 % and 61.9 % at 3 and 5 years. No significant difference in glomerular filtration rates before and after the procedure was observed (P = 0.107). The major complications rate was 5.9 % per session with an increased risk in the case of central locations (P = 0.006).
Conclusions
Percutaneous renal RFA appears to be safe and effective with useful nephron-sparing results.
Key Points
• Radiofrequency ablation (RFA) is a well-tolerated technique according to mid-term results.
• RFA for malignant renal tumours preserved renal function in high-risk patients.
• Mid-term efficacy of RFA was close to that of formal conservative surgery.
• Tumour size and central location limit the efficacy and safety of RFA.