Skip to main content
Erschienen in: CardioVascular and Interventional Radiology 4/2007

01.07.2007 | Clinical Investigation

Radiofrequency Ablation in Combination with Embolization in Metachronous Recurrent Renal Cancer in Solitary Kidney after Contralateral Tumor Nephrectomy

verfasst von: Bernhard Gebauer, Michael Werk, Enrique Lopez-Hänninen, Roland Felix, Peter Althaus

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 4/2007

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To evaluate the feasibility and safety of minimally invasive, percutaneous techniques in metachronous recurrent renal cell cancers (RCCs) in solitary kidneys.

Methods

In 4 patients, recurrent RCC was treated by radiofrequency ablation (RFA) (RITA, StarBurst) alone, and in 2 patients by RFA in combination with superselective transarterial particle-lipiodol embolization using 3 Fr microcatheters. RFA was guided by computed tomography in 5 patients, and by magnetic resonance imaging in 1 patient. Mean tumor diameter was 26.7 mm (range 10–45 mm). All interventions were technically successful; during follow-up 1 patient developed recurrent RCC, which was retreated by RFA after embolization.

Results

No major peri- or postprocedural complications occurred. Changes in creatinine (pre- vs. post-intervention, 122 vs. 127 μmol/l) and calculated creatinine clearance (pre- vs. post-intervention, 78 vs. 73 ml/min) after ablation were minimal.

Conclusion

In single kidneys, percutaneous, minimally invasive techniques are safe and feasible. In large tumors, or where there are adjacent critical structures, we prefer a combination of embolization and thermal ablation (RFA).
Literatur
1.
Zurück zum Zitat Mitchell RE, Gilbert SM, Murphy AM, et al. (2006) Partial nephrectomy and radical nephrectomy offer similar cancer outcomes in renal cortical tumors 4 cm or larger. Urology 67:260–264PubMedCrossRef Mitchell RE, Gilbert SM, Murphy AM, et al. (2006) Partial nephrectomy and radical nephrectomy offer similar cancer outcomes in renal cortical tumors 4 cm or larger. Urology 67:260–264PubMedCrossRef
2.
Zurück zum Zitat Nieder AM, Taneja SS (2003) The role of partial nephrectomy for renal cell carcinoma in contemporary practice. Urol Clin North Am 30:529–542PubMedCrossRef Nieder AM, Taneja SS (2003) The role of partial nephrectomy for renal cell carcinoma in contemporary practice. Urol Clin North Am 30:529–542PubMedCrossRef
3.
Zurück zum Zitat Mayo-Smith WW, Dupuy DE, Parikh PM, et al. (2003) Imaging-guided percutaneous radiofrequency ablation of solid renal masses: Techniques and outcomes of 38 treatment sessions in 32 consecutive patients. AJR Am J Roentgenol 180:1503–1508PubMed Mayo-Smith WW, Dupuy DE, Parikh PM, et al. (2003) Imaging-guided percutaneous radiofrequency ablation of solid renal masses: Techniques and outcomes of 38 treatment sessions in 32 consecutive patients. AJR Am J Roentgenol 180:1503–1508PubMed
4.
Zurück zum Zitat Gervais DA, Arellano RS, Mueller PR (2005) Percutaneous radiofrequency ablation of renal cell carcinoma. Eur Radiol 15:960–967PubMedCrossRef Gervais DA, Arellano RS, Mueller PR (2005) Percutaneous radiofrequency ablation of renal cell carcinoma. Eur Radiol 15:960–967PubMedCrossRef
5.
Zurück zum Zitat Varkarakis IM, Allaf ME, Inagaki T, et al. (2005) Percutaneous radio frequency ablation of renal masses: Results at a 2-year mean followup. J Urol 174:456–460; discussion 460PubMedCrossRef Varkarakis IM, Allaf ME, Inagaki T, et al. (2005) Percutaneous radio frequency ablation of renal masses: Results at a 2-year mean followup. J Urol 174:456–460; discussion 460PubMedCrossRef
6.
Zurück zum Zitat Matlaga BR, Zagoria RJ, Woodruff RD, et al. (2002) Phase II trial of radio frequency ablation of renal cancer: Evaluation of the kill zone. J Urol 168:2401–2405PubMedCrossRef Matlaga BR, Zagoria RJ, Woodruff RD, et al. (2002) Phase II trial of radio frequency ablation of renal cancer: Evaluation of the kill zone. J Urol 168:2401–2405PubMedCrossRef
7.
Zurück zum Zitat Gervais DA, McGovern FJ, Arellano RS, et al. (2003) Renal cell carcinoma: Clinical experience and technical success with radio-frequency ablation of 42 tumors. Radiology 226:417–424PubMedCrossRef Gervais DA, McGovern FJ, Arellano RS, et al. (2003) Renal cell carcinoma: Clinical experience and technical success with radio-frequency ablation of 42 tumors. Radiology 226:417–424PubMedCrossRef
8.
Zurück zum Zitat Pavlovich CP, Walther MM, Choyke PL, et al. (2002) Percutaneous radio frequency ablation of small renal tumors: Initial results. J Urol 167:10–15PubMedCrossRef Pavlovich CP, Walther MM, Choyke PL, et al. (2002) Percutaneous radio frequency ablation of small renal tumors: Initial results. J Urol 167:10–15PubMedCrossRef
9.
Zurück zum Zitat Buscarini L, Buscarini E, Di Stasi M, et al. (1999) Percutaneous radiofrequency thermal ablation combined with transcatheter arterial embolization in the treatment of large hepatocellular carcinoma. Ultraschall Med 20:47–53PubMedCrossRef Buscarini L, Buscarini E, Di Stasi M, et al. (1999) Percutaneous radiofrequency thermal ablation combined with transcatheter arterial embolization in the treatment of large hepatocellular carcinoma. Ultraschall Med 20:47–53PubMedCrossRef
10.
Zurück zum Zitat Yamakado K, Nakatsuka A, Akeboshi M, et al. (2004) Combination therapy with radiofrequency ablation and transcatheter chemoembolization for the treatment of hepatocellular carcinoma: Short-term recurrences and survival. Oncol Rep 11:105–109PubMed Yamakado K, Nakatsuka A, Akeboshi M, et al. (2004) Combination therapy with radiofrequency ablation and transcatheter chemoembolization for the treatment of hepatocellular carcinoma: Short-term recurrences and survival. Oncol Rep 11:105–109PubMed
11.
Zurück zum Zitat Bani-Hani AH, Leibovich BC, Lohse CM, et al. (2005) Associations with contralateral recurrence following nephrectomy for renal cell carcinoma using a cohort of 2352 patients. J Urol 173:391–394PubMedCrossRef Bani-Hani AH, Leibovich BC, Lohse CM, et al. (2005) Associations with contralateral recurrence following nephrectomy for renal cell carcinoma using a cohort of 2352 patients. J Urol 173:391–394PubMedCrossRef
12.
Zurück zum Zitat Henriksson C, Geterud K, Aldenborg F, et al. (1992) Bilateral asynchronous renal cell carcinoma. Computed tomography of the contralateral kidney 10–43 years after nephrectomy. Eur Urol 22:209–212PubMed Henriksson C, Geterud K, Aldenborg F, et al. (1992) Bilateral asynchronous renal cell carcinoma. Computed tomography of the contralateral kidney 10–43 years after nephrectomy. Eur Urol 22:209–212PubMed
13.
Zurück zum Zitat Rabbani F, Herr HW, Almahmeed T, et al (2002) Temporal change in risk of metachronous contralateral renal cell carcinoma: influence of tumor characteristics and demographic factors. J Clin Oncol 20:2370–2375PubMedCrossRef Rabbani F, Herr HW, Almahmeed T, et al (2002) Temporal change in risk of metachronous contralateral renal cell carcinoma: influence of tumor characteristics and demographic factors. J Clin Oncol 20:2370–2375PubMedCrossRef
14.
Zurück zum Zitat Grimaldi G, Reuter V, Russo P (1998) Bilateral non-familial renal cell carcinoma. Ann Surg Oncol 5:548–552PubMedCrossRef Grimaldi G, Reuter V, Russo P (1998) Bilateral non-familial renal cell carcinoma. Ann Surg Oncol 5:548–552PubMedCrossRef
15.
Zurück zum Zitat Park JH, Kim SH, Han JK, et al. (1994) Transcatheter arterial embolization of unresectable renal cell carcinoma with a mixture of ethanol and iodized oil. Cardiovasc Intervent Radiol 17:323–327PubMedCrossRef Park JH, Kim SH, Han JK, et al. (1994) Transcatheter arterial embolization of unresectable renal cell carcinoma with a mixture of ethanol and iodized oil. Cardiovasc Intervent Radiol 17:323–327PubMedCrossRef
16.
Zurück zum Zitat Omary RA, Bettmann MA, Cardella JF, et al. (2003) Quality improvement guidelines for the reporting and archiving of interventional radiology procedures. J Vasc Interv Radiol 14:S293–295PubMed Omary RA, Bettmann MA, Cardella JF, et al. (2003) Quality improvement guidelines for the reporting and archiving of interventional radiology procedures. J Vasc Interv Radiol 14:S293–295PubMed
17.
Zurück zum Zitat Sacks D, McClenny TE, Cardella JF, et al. (2003) Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol 14:S199–202PubMed Sacks D, McClenny TE, Cardella JF, et al. (2003) Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol 14:S199–202PubMed
18.
Zurück zum Zitat Thomis JA, Soep HH, Hallynck T, et al. (1982) Creatinine clearance, different methods of determination. Br J Clin Pharmacol 13:260–262PubMed Thomis JA, Soep HH, Hallynck T, et al. (1982) Creatinine clearance, different methods of determination. Br J Clin Pharmacol 13:260–262PubMed
19.
Zurück zum Zitat Gervais DA, Arellano RS, Mueller P (2005) Percutaneous ablation of kidney tumors in nonsurgical candidates. Oncology (Williston Park) 19(11 Suppl 4):6–11 Gervais DA, Arellano RS, Mueller P (2005) Percutaneous ablation of kidney tumors in nonsurgical candidates. Oncology (Williston Park) 19(11 Suppl 4):6–11
20.
Zurück zum Zitat den Brok MH, Sutmuller RP, van der Voort R, et al. (2004) In situ tumor ablation creates an antigen source for the generation of antitumor immunity. Cancer Res 64:4024–4029CrossRef den Brok MH, Sutmuller RP, van der Voort R, et al. (2004) In situ tumor ablation creates an antigen source for the generation of antitumor immunity. Cancer Res 64:4024–4029CrossRef
21.
Zurück zum Zitat Goldberg SN, Gazelle GS, Mueller PR (2000) Thermal ablation therapy for focal malignancy: A unified approach to underlying principles, techniques, and diagnostic imaging guidance. AJR Am J Roentgenol 174:323–331PubMed Goldberg SN, Gazelle GS, Mueller PR (2000) Thermal ablation therapy for focal malignancy: A unified approach to underlying principles, techniques, and diagnostic imaging guidance. AJR Am J Roentgenol 174:323–331PubMed
22.
Zurück zum Zitat Pennes HH (1948) Analysis of tissue and arterial blood temperatures in the resting human forearm. J Appl Physiol 1:93–122 Pennes HH (1948) Analysis of tissue and arterial blood temperatures in the resting human forearm. J Appl Physiol 1:93–122
23.
Zurück zum Zitat Hall WH, McGahan JP, Link DP, et al. (2000) Combined embolization and percutaneous radiofrequency ablation of a solid renal tumor. AJR Am J Roentgenol 174:1592–1594PubMed Hall WH, McGahan JP, Link DP, et al. (2000) Combined embolization and percutaneous radiofrequency ablation of a solid renal tumor. AJR Am J Roentgenol 174:1592–1594PubMed
24.
Zurück zum Zitat Tacke J, Mahnken A, Bucker A, et al. (2001) Nephron-sparing percutaneous ablation of a 5 cm renal cell carcinoma by superselective embolization and percutaneous RF-ablation. Rofo 173:980–983PubMed Tacke J, Mahnken A, Bucker A, et al. (2001) Nephron-sparing percutaneous ablation of a 5 cm renal cell carcinoma by superselective embolization and percutaneous RF-ablation. Rofo 173:980–983PubMed
25.
Zurück zum Zitat Yamakado K, Nakatsuka A, Kobayashi S, et al. (2006) Radiofrequency ablation combined with renal arterial embolization for the treatment of unresectable renal cell carcinoma larger than 3.5 cm: Initial experience. Cardiovasc Intervent Radiol ??: ???? Yamakado K, Nakatsuka A, Kobayashi S, et al. (2006) Radiofrequency ablation combined with renal arterial embolization for the treatment of unresectable renal cell carcinoma larger than 3.5 cm: Initial experience. Cardiovasc Intervent Radiol ??: ????
26.
Zurück zum Zitat Almgard LE, Slezak P (1977) Treatment of renal adenocarcinoma by embolization: A follow-up of 38 cases. Eur Urol 3:279–281PubMed Almgard LE, Slezak P (1977) Treatment of renal adenocarcinoma by embolization: A follow-up of 38 cases. Eur Urol 3:279–281PubMed
27.
Zurück zum Zitat Lalli AF, Peterson N, Bookstein JJ (1969) Roentgen-guided infarctions of kidneys and lungs: A potential therapeutic technique. Radiology 93:434–435PubMed Lalli AF, Peterson N, Bookstein JJ (1969) Roentgen-guided infarctions of kidneys and lungs: A potential therapeutic technique. Radiology 93:434–435PubMed
Metadaten
Titel
Radiofrequency Ablation in Combination with Embolization in Metachronous Recurrent Renal Cancer in Solitary Kidney after Contralateral Tumor Nephrectomy
verfasst von
Bernhard Gebauer
Michael Werk
Enrique Lopez-Hänninen
Roland Felix
Peter Althaus
Publikationsdatum
01.07.2007
Verlag
Springer-Verlag
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 4/2007
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-007-9012-y

Weitere Artikel der Ausgabe 4/2007

CardioVascular and Interventional Radiology 4/2007 Zur Ausgabe

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.