Management of Renal Tumors by Image-Guided Radiofrequency Ablation: Experience in 105 Tumors

Breen, David J.; Rutherford, E.E.; Stedman, Brian; Roy-Choudhury, Shuvro; Cast, J.E.I.; Hayes, Matthew; Smart, C. J.

doi:10.1007/s00270-007-9090-x

Cited by 124 publications

(71 citation statements)

References 23 publications

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“…After the application of a second RFA in this case, the subsequent first month control showed no enhancing, viable, residual tumor. Therefore, the overall success rate was accepted as 100%, which was comparable to the previous literature (Arima et al, 2007;Breen et al, 2007;Mylona et al, 2009;Salas et al, 2010;Altunrende et al, 2011;Iannuccilli et al, 2012;. The presence of incomplete ablation at initial RFA only in USG-PRFA application was supposed that the preferred technique could influence the RFA results.…”

Section: Resultssupporting

confidence: 68%

Analysis of Radiofrequency Ablation of Small Renal Tumors in Patients at High Anesthetic and Surgical Risk: Urologist Experience with Follow-up Results in the Initial Six Months

Yüksel

Karakose²,

Gümüş³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Section: Resultssupporting

confidence: 68%

Analysis of Radiofrequency Ablation of Small Renal Tumors in Patients at High Anesthetic and Surgical Risk: Urologist Experience with Follow-up Results in the Initial Six Months

Yüksel

Karakose²,

Gümüş³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…In view of these factors, and because current evidence is based mainly on single-centre series and a few meta-analyses, there is uncertainty about the best treatment of SRMs. [9][10][11][12] Minimally invasive ablation SRMs (of < 4 cm in size) clearly make available a new treatment option, but robust data comparing relative clinical effectiveness and cost-effectiveness of active surveillance with ablative techniques (RFA/CRYO) are currently not available. A randomised controlled trial (RCT) to answer this question has been identified as a priority by the renal cancer subgroup of the National Cancer Research Institute (NCRI) and has the support of the British Association of Urological Surgeons (BAUS) section of oncology and local National Institute for Health Research (NIHR) clinical research networks.…”

Section: Fundingmentioning

confidence: 99%

Surveillance versus ablation for incidentally diagnosed small renal tumours: the SURAB feasibility RCT

Soomro

Lecouturier

Stocken

et al. 2017

Health Technol Assess

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Background There is uncertainty around the appropriate management of small renal tumours. Treatments include partial nephrectomy, ablation and active surveillance. Objectives To explore the feasibility of a randomised trial of ablation versus active surveillance. Design Two-stage feasibility study: stage 1 – clinician survey and co-design work; and stage 2 – randomised feasibility study with qualitative and economic components. Methods Stage 1 – survey of radiologists and urologists, and development of patient information materials. Stage 2 – patients identified across eight UK centres with small renal tumours (< 4 cm) were randomised (1 : 1 ratio) to ablation or active surveillance in an unblinded manner. Randomisation was carried out by a central computer system. The primary objective was to determine willingness to participate and to randomise a target of 60 patients. The qualitative and economic data were collected separately. Results The trial was conducted across eight centres, with a site-specific period of recruitment ranging from 3 to 11 months. Of the 154 patients screened, 36 were eligible and were provided with study details. Seven agreed to be randomised and one patient was found ineligible following biopsy results. Six patients (17% of those eligible) were randomised: three patients received ablation and no serious adverse events were recorded. The 3- and 6-month data were collected for four (67%) and three (50%) out of the six patients, respectively. The qualitative substudy identified factors directly impacting on the recruitment of this trial. These included patient and clinician preferences, organisational factors (variation in clinical pathway) and standard treatment not included. The health economic questionnaire was designed and piloted; however, the sample size of recruited patients was insufficient to draw a conclusion on the feasibility of the health economics. Conclusions The trial did not meet the criteria for progression and the recruitment rate was lower than hypothesised, demonstrating that a full trial is presently not possible. The qualitative study identified factors that led to variation in recruitment across the sites. Implementation of organisational and operational measures can increase recruitment in any future trial. There was insufficient information to conduct a full economic analysis. Trial registration Current Controlled Trials ISRCTN31161700. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 81. See the NIHR Journals Library website for further project information.

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“…RFA [31][32][33][34][35][36][37][38][39][40][41] ) that met all inclusion criteria and were included in the meta-analysis of case series studies.…”

Section: Absence Of Rcts On Ca Compared To Rfa For Renal Cell Carcinomamentioning

confidence: 99%

An alternative approach to deal with the absence of clinical trials: a proportional meta-analysis of case series studies

2013

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PURPOSE: Systematic reviews are criticized for frequently offering inconsistent evidences and absence of straightforward recommendations. Their value seems to be depreciated when the conclusions are uncertain. To describe an alternative approach of evaluating case series studies in health care when there is absence of clinical trials. METHODS:We provide illustrations from recent experiences. Proportional meta-analysis was performed on surgical outcomes: (a) case series studies, (b) use of cryoablation or radiofrequency ablation, and (c) patients with small renal cell carcinoma. The statistically significant difference between both interventions studied was defined if their combined 95% confidential interval (CI) did not overlap. RESULTS:As demonstrated by the example, this analysis is an alternative approach to provide some evidence of the intervention´s effects under evaluation and plotting all available case series in the absence of clinical trials for the health field. CONCLUSIONS:Although we are leading to a low level of evidence to determine efficacy, effectiveness and safety of interventions this alternative approach can help surgeons, physicians and health professionals for a provisionally decision in health care along with their clinical expertise and the patient´s wishes and circumstances in the absence of high-quality primary studies. It´s not a replacement for the gold standard randomized clinical trial, but an alternative analysis for clinical research. An alternative approach to deal with the absence of clinical trials.A proportional meta-analysis of case series studies

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Management of Renal Tumors by Image-Guided Radiofrequency Ablation: Experience in 105 Tumors

Cited by 124 publications

References 23 publications

Analysis of Radiofrequency Ablation of Small Renal Tumors in Patients at High Anesthetic and Surgical Risk: Urologist Experience with Follow-up Results in the Initial Six Months

Analysis of Radiofrequency Ablation of Small Renal Tumors in Patients at High Anesthetic and Surgical Risk: Urologist Experience with Follow-up Results in the Initial Six Months

Surveillance versus ablation for incidentally diagnosed small renal tumours: the SURAB feasibility RCT

An alternative approach to deal with the absence of clinical trials: a proportional meta-analysis of case series studies

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