Incomplete thermal ablation stimulates proliferation of residual renal carcinoma cells in a translational murine model

Kroeze, S.G.C.; Melick, Harm H.E. van; Nijkamp, Maarten W.; Kruse, Fabian K.; Kruijssen, Laura; Diest, Paul J. van; Bosch, J.L.H. Ruud; Jans, Judith

doi:10.1111/j.1464-410x.2012.11261.x

Cited by 32 publications

(31 citation statements)

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“…Stimulated growth of surviving tumor cells after incomplete thermal ablation (cryoablation or radiofrequency ablation) was observed earlier in renal tumor cells [22] and after incomplete radiofrequency ablation in liver cells [23]. Increased tumor cell proliferation was seen up to the end of the studies, respectively, 14 and 21 days after ablation, and is possibly caused by tissue damage, increased hypoxia, increased presence of heat-shock proteins, and inflammatory cells directly adjacent to the ablation area [22].…”

Section: Discussionmentioning

confidence: 99%

“…Increased tumor cell proliferation was seen up to the end of the studies, respectively, 14 and 21 days after ablation, and is possibly caused by tissue damage, increased hypoxia, increased presence of heat-shock proteins, and inflammatory cells directly adjacent to the ablation area [22]. The clinical consequences of this effect remain unclear; in the worst-case scenario, it could facilitate tumor outgrowth; and in the best case scenario, the effect is only a temporary reaction on the cellular damage caused by the ablation.…”

Section: Discussionmentioning

confidence: 99%

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MRI-guided focal laser ablation for prostate cancer followed by radical prostatectomy: correlation of treatment effects with imaging

et al. 2016

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PurposeTo correlate treatment effects of MRI-guided focal laser ablation in patients with prostate cancer with imaging using prostatectomy as standard of reference.MethodsThis phase I study was approved by the Institutional Review Board. Three weeks prior to prostatectomy, five patients with histopathologically proven, low/intermediate grade prostate cancer underwent transrectal MRI-guided focal laser ablation. Per patient, only one ablation was performed to investigate the effect of ablation on the tissue rather than the effectiveness of ablation. Ablation was continuously monitored with real-time MR temperature mapping, and damage-estimation maps were computed. A post-ablation high-resolution T1-weighted contrast-enhanced sequence was acquired. Ablation volumes were contoured and measured on histopathology specimens (with a shrinkage factor of 1.15), T1-weighted contrast-enhanced images, and damage-estimation maps, and were compared.ResultsA significant volume correlation was seen between the ablation zone on T1-weighted contrast-enhanced images and the whole-mount histopathology section (r = 0.94, p = 0.018). The damage-estimation maps and histopathology specimen showed a correlation of r = 0.33 (p = 0.583). On histopathology, the homogeneous necrotic area was surrounded by a reactive transition zone (1–5 mm) zone, showing neovascularisation, and an increased mitotic index, indicating increased tumor activity.ConclusionsThe actual ablation zone was better indicated by T1-weighted contrast-enhanced than by damage-estimation maps. Histopathology results highlight the importance of complete tumor ablation with a safety margin.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

MRI-guided focal laser ablation for prostate cancer followed by radical prostatectomy: correlation of treatment effects with imaging

et al. 2016

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“…In contrast with rapid progression in HCC, there are few reports regarding that in RCC. Kroeze et al (29) reported that incomplete thermal ablation stimulated proliferation of residual RCC cells in a murine model. To the best of our knowledge, only one study has previously demonstrated rapid progression following laparoscopic RFA for T1b RCC (4.5 cm) (24).…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of percutaneous radiofrequency ablation for small renal cancer

et al. 2017

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Abstract. Partial nephrectomy is the treatment of choice for small renal cell carcinoma (RCC) from the perspective of cancer management and renal function. However, when patients with RCC are of advanced age, exhibit severe comorbidities, including cardiovascular and pulmonary diseases, or have hereditary RCC, ablative therapies, including radiofrequency ablation (RFA) and cryoablation are useful treatment options. In the present study, the clinical outcomes of percutaneous RFA for treating small RCC were evaluated. Between December 2005 and March 2015, 40 patients (41 renal tumors in total) underwent RFA and a total of 50 sessions of RFA were performed. The average tumor size was 2.5 cm. A total of 18 tumors were exophytic and 23 were parenchymal. Of the 41 tumors, 85.4% were completely ablated by initial RFA and the rate of complete ablation following reablation for residual viable lesions was 95.1%. Local recurrence-free survival following complete ablation was 84.2% at 3 years. A patient with a 4.7 cm RCC tumor rapidly progressed following four RFA treatments until complete ablation was achieved. The metastasis-free survival rate following initial RFA was 95.7% at 3 years. The RCC-specific survival was 100% (mean follow-up, 38 months). Adverse events occurred in five sessions (10%); however, only 1 patient with arteriovenous fistula required intervention (transarterial embolization). The mean hospital stay following RFA was 3.2 days. The mean decrease in estimated glomerular filtration rate following RFA was 2.7%. The results of the present study indicate that percutaneous RFA was an effective treatment for small RCCs with respect to management of cancer, minimal invasiveness and minimal loss of renal function, particularly in patients for whom surgery would be a high risk and those at increased risk of deterioration of renal function.

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“…However, there is increasing clinical and experimental evidence that RF ablation may, in fact, also induce tumor initiation, growth, and propagation (1,4,5). Several studies suggest that RF ablation may, under unclear clinical circumstances and owing to poorly characterized mechanisms, stimulate growth in residual incompletely treated and viable tumor surrounding the ablation zone for at least some tumor types (eg, HCC or renal cell carcinoma) (4,6,7).…”

Section: Implications For Patient Carementioning

confidence: 99%

Hepatic Radiofrequency Ablation–induced Stimulation of Distant Tumor Growth Is Suppressed by c-Met Inhibition

Ahmed¹,

Kumar²,

Moussa³

et al. 2016

Radiology

108

147

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Incomplete thermal ablation stimulates proliferation of residual renal carcinoma cells in a translational murine model

Cited by 32 publications

References 28 publications

MRI-guided focal laser ablation for prostate cancer followed by radical prostatectomy: correlation of treatment effects with imaging

MRI-guided focal laser ablation for prostate cancer followed by radical prostatectomy: correlation of treatment effects with imaging

Clinical outcomes of percutaneous radiofrequency ablation for small renal cancer

Hepatic Radiofrequency Ablation–induced Stimulation of Distant Tumor Growth Is Suppressed by c-Met Inhibition

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