OncologyLong-term Outcomes After Percutaneous Radiofrequency Ablation for Renal Cell Carcinoma
Section snippets
Material and Methods
This retrospective study was approved by the institutional review board at our institution. We conducted a review of patients who underwent percutaneous RFA at our institution before 2005 and identified 41 patients treated for 48 index lesions. All of these patients had pretreatment abdominal CT or MRI and chest evaluation with chest radiography or chest CT. Patients in this cohort were initially evaluated by a urologist who assessed surgical risk. All of these patients had serious
Results
A total of 48 RCCs in 41 patients were treated with CT-guided percutaneous RFA. Four patients were treated for multiple RCCS: 2 patients had 2 tumors, 1 had 3 tumors, and 1 had 4. Of the 41 patients, there were 31 (76%) males and 10 (24%) females. The median age of patients was 72 (interquartile range [IQR]: 61-78) at the time of treatment. The median size of RCC treated was 2.6 cm (IQR: 1.7-3.6). The largest tumor was 8.2 cm. There were 4 (8%) complications, 2 small asymptomatic
Comment
Standard therapy for RCC has been surgical extirpation. Surgical options include both radical and partial nephrectomy,10, 11, 12, 13, 14, 15, 16 with the requirement of using general anesthesia. It is not rare to encounter patients with small RCCs who are unable, because of co-morbidities, to safely undergo surgical resection, or patients in whom renal sparing surgery is not possible even though adequate renal function after resection will likely be compromised. Active surveillance of these
Conclusions
The results of this study indicate that percutaneous RFA at a high-volume center is safe, and can result in durable oncological control for RCCs less than 4 cm. For these tumors, no local recurrences occurred with median follow up of 61 months for patients alive at the end of this study. For larger RCCs the risk of incomplete ablation is substantially higher and surgery is advisable for these patients. These data support the use of CT-guided percutaneous radiofrequency ablation for the
References (26)
- et al.
Immediate and long-term CT appearances following radiofrequency ablation of renal tumors
Clin Radiol
(2008) - et al.
Long-term follow up of patients with renal cell carcinoma treated with radio frequency ablation with curative intent
J Urol
(2005) - et al.
The results of radical nephrectomy for renal cell carcinoma
J Urol
(1969) - et al.
Nephron sparing surgery for renal tumors: indications, techniques and outcomes
J Urol
(2001) - et al.
7-year oncological outcomes after laparoscopic and open partial nephrectomy
J Urol
(2010) - et al.
Safety and efficacy of partial nephrectomy for all T1 tumors based on an international multicenter experience
J Urol
(2004) - et al.
Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors
J Urol
(2007) - et al.
Tumor size is associated with malignant potential in renal cell carcinoma cases
J Urol
(2009) - et al.
Positive surgical margins at partial nephrectomy: predictors and oncological outcomes
J Urol
(2008) - et al.
Complications after radical and partial nephrectomy as a function of age
J Urol
(2010)
Percutaneous renal cryoablation: experience treating 115 tumors
J Urol
Patterns of tumor recurrence and guidelines for followup after nephron sparing surgery for sporadic renal cell carcinoma
J Urol
Effect of renal cancer size on the prevalence of metastasis at diagnosis and mortality
J Urol
Cited by (130)
Effectiveness of Thermal Ablation for Renal Cell Carcinoma after Prior Partial Nephrectomy
2023, European Urology Open ScienceACR Appropriateness Criteria® Post-Treatment Follow-up and Active Surveillance of Clinically Localized Renal Cell Carcinoma: 2021 Update
2022, Journal of the American College of RadiologyLocal anesthesia for percutaneous US/CT-guided bipolar radiofrequency ablation of small renal masses: A safe and feasible alternative
2021, Urologic Oncology: Seminars and Original InvestigationsAblation of Renal Cell Carcinoma
2020, Image-Guided Interventions: Expert Radiology Series, Third EditionLong-Term Survival after Percutaneous Radiofrequency Ablation of Pathologically Proven Renal Cell Carcinoma in 100 Patients
2020, Journal of Vascular and Interventional Radiology