Optimal Lesion Assessment Following Acute Radio Frequency Ablation of Porcine Kidney: Cellular Viability or Histopathology?

Marcovich, Robert; Aldana, Joel Patrick A.; Morgenstern, Nora; Jacobson, Avrum; Smith, Arthur D.; Lee, Benjamin R.

doi:10.1097/01.ju.0000073846.32015.45

Cited by 59 publications

(29 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Davenport et al [13] showed in a 2009 series of RFA follow-up that the post-ablation beds of tumors < 3 cm could show enlargement up to 2 months. The role of biopsy has conflicting evidence, limited by high false positive rates due to heat fixing effects on tissue [14] but demonstrated to identify malignant disease in the absence of radiological signs [15]. The post-RFA optimal follow-up and recurrence criteria remain poorly defined.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency Ablation of Small Renal Masses: Outcomes, Complications and Effects on Renal Function

Curry¹,

Pahuja²,

Loan³

et al. 2018

Current Urology

View full text Add to dashboard Cite

Introduction: To describe oncological outcomes, effects on renal function and complications with radiofrequency ablation (RFA) of T1 renal tumors in an 8-year experience. Materials and Methods: A retrospective study of RFA in 89 consecutive patients between 2005 and 2013 was undertaken. Those with metastatic disease, incomplete follow-up, genetic pre-disposition to renal tumors and biopsy proven benign pathology were excluded, with 79 patients meeting inclusion criteria. Data was collected on demographics, oncological outcomes, complications and effects on renal function. Results: We demonstrate 94% disease-free survival at median follow-up of 29 months in a population consisting of 42 T1a and 37 T1b tumors. No disease related deaths were recorded in the follow-up period. Post-RFA decline in renal function was shown to correlate with tumor size and increased age (p = 0.0009/0.0021). Pre-existing renal impairment was a risk for post-RFA function decline (p < 0.005). Two complications were encountered in the series. Conclusion: RFA produces durable oncological outcomes in T1 tumors with a minimal effect on renal function and low risk of complications. Patients at risk of developing renal impairment can be identified from described risk factors.

show abstract

Section: Discussionmentioning

confidence: 99%

Radiofrequency Ablation of Small Renal Masses: Outcomes, Complications and Effects on Renal Function

Curry¹,

Pahuja²,

Loan³

et al. 2018

Current Urology

View full text Add to dashboard Cite

show abstract

“…For example, we have previously shown in liver tumors that specialized stains are required to identify ablated tumor, particularly in the acute postablation period (2). Hence, the precise role of pathological assessment after RF ablation patients has been questioned (44).…”

Section: Assessing For Successful Radiofrequency Ablationmentioning

confidence: 99%

Review of Radiofrequency Ablation for Renal Cell Carcinoma

Hines-Peralta

Goldberg

2004

Clinical Cancer Research

View full text Add to dashboard Cite

This review will discuss how minimally invasive, imageguided radiofrequency (RF) tumor ablation [i.e., coagulating tumor using short-duration heating (<15 minutes) by directly applying temperatures >50°C via needle electrodes] is being incorporated as a clinical tool for the treatment of renal cell carcinoma. RF ablation has been used to treat focal liver tumors. Potential benefits of this thermal therapy include reduced morbidity and mortality compared with standard surgical resection and the ability to treat nonsurgical patients. More recently, this technique has been introduced to treat focal renal tumors, particularly incidental lesions smaller than 3 cm in elderly patients and those with comorbid conditions. Other uses have included treatment in patients with von Hippel-Lindau syndrome and other diseases that predispose patients to multiple renal carcinomas, where renal parenchymal preservation is desired. Techniques, complications, and results will be discussed. Additionally, strategies that we are currently studying to improve RF outcomes and enable the potential treatment of larger tumors will be addressed. Most notably, recent data on increased coagulation achieved by combining RF ablation with antivascular/antiangiogenic therapies, such as arsenic trioxide, that reduce blood flow and promote heat retention are provided.

show abstract

“…This has become a particularly paramount issue for RFA where the histologic architecture is well preserved acutely after ablation. There is, however, convincing data to suggest that neither H&E nor oxidative markers are a reliable means to assess tissue viability immediately after a thermal insult [26,49,50]. Thus, particularly for RFA, immediate post-ablative biopsy and staining may not accurately reflect cell death or viability.…”

Section: Definition Of Treatment Successmentioning

confidence: 92%

“…Indeed, a principal criticism by extirpative surgeons is that ablation fails to provide complete pathologic confirmation of tumor death. In an attempt to address this issue, several studies have debated the utilization of hematoxylin and eosin (H&E), NADH diaphorase, and other oxidative stress stains to assess cell viability in resected specimens immediately following ablation [49][50][51]. This has become a particularly paramount issue for RFA where the histologic architecture is well preserved acutely after ablation.…”

Section: Definition Of Treatment Successmentioning

confidence: 98%

Renal ablative therapy: Radiofrequency ablation and cryoablation

Raman

Hall

Cadeddu

2009

Journal of Surgical Oncology

View full text Add to dashboard Cite

Widespread use of cross-sectional imaging has contributed to an increase in diagnosis of small renal masses. While extirpation has historically been the "gold standard" for managing such tumors, thermal ablation is increasingly utilized as primary surgical therapy. Contemporary series suggest that ablative procedures maintain oncologic outcomes similar to extirpation while minimizing patient morbidity. As more renal masses are diagnosed in elderly or comorbid patients, ablation will likely assume a central role in management strategies.

show abstract

Optimal Lesion Assessment Following Acute Radio Frequency Ablation of Porcine Kidney: Cellular Viability or Histopathology?

Cited by 59 publications

References 15 publications

Radiofrequency Ablation of Small Renal Masses: Outcomes, Complications and Effects on Renal Function

Radiofrequency Ablation of Small Renal Masses: Outcomes, Complications and Effects on Renal Function

Review of Radiofrequency Ablation for Renal Cell Carcinoma

Renal ablative therapy: Radiofrequency ablation and cryoablation

Contact Info

Product

Resources

About