Radiofrequency Ablation and Cryoablation of Renal Tumours

Kwan, Kevin; Matsumoto, Edward D.

doi:10.3747/co.2007.113

Cited by 29 publications

(11 citation statements)

References 62 publications

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“…Complications of RFA can be divided as minor (Clavien Grade I or II) and major (Clavien Grade III, IV, V). The reported complications include a perinephric hematoma, gross hematuria, pyonephrosis, ureteral stricture, damage to adjacent organs, pain, and paresthesis ( 27 , 28 ). In the present study, 19 complications occurred in 17 sessions for an overall complication rate of 35.8%.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency Ablation of Renal Tumors: Four-Year Follow-Up Results in 47 Patients

2012

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ObjectiveTo retrospectively evaluate the intermediate results of radiofrequency ablation (RFA) of small renal masses (SRMs).Materials and MethodsPercutaneous or laparoscopic RFA was performed on 48 renal tumors in 47 patients. The follow-up studies included a physical examination, chest radiography, creatinine level, and contrast-enhanced CT or MRI. To confirm the pathologic criteria of complete ablation, 35 patients underwent a follow-up biopsy. Recurrence was defined as contrast enhancement on imaging studies after 3 months, lesion growth at subsequent imaging, or viable cancer cells on follow-up biopsy.ResultsTechnical success was achieved in 43 (89.6%) of 48 renal tumors. The mean tumor size was 2.3 cm and the mean follow-up period was 49.6 months. Repeated RFA was necessary in 5 tumors due to incomplete ablation. The overall complication rate was 35.8%, of which 96.2% were mild complications. Serum creatinine levels at 12 months after RFA did not differ from those before RFA (1.28 vs. 1.36 mg/dL). Four patients were found to have recurrence at various follow-up intervals, and distant metastasis was not found in any cases.ConclusionRFA appears to be a useful treatment for selected patients with SRMs. Our 4-year follow-up results disclose an excellent therapeutic outcome with RFA, while achieving effective local tumor control.

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Section: Discussionmentioning

confidence: 99%

Radiofrequency Ablation of Renal Tumors: Four-Year Follow-Up Results in 47 Patients

2012

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“…Complications of RFA can be divided into major (requiring intervention) and minor complications (conservative observation). The reported complications include perinephric hematoma, gross hematuria, pyonephrosis, ureteral stricture, damage to adjacent organs, pain, and paresthesias [ 24 , 25 ]. In the present study, 23 (47%) complications occurred, which included perinephric hematoma in 13, gross hematuria in 3, perinephric fluid collection in 3, a mild thermal injury of the psoas muscle, a bowel injury with mild hydronephrosis, a liver injury, and thermal injury of the pelvocaliceal system.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency Ablation of Renal Tumors: Our Experience

Kim

et al. 2011

Korean J Urol

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PurposeTo report our results of nephron-sparing radiofrequency ablation (RFA) of renal tumors.Materials and MethodsSince August 2004, 49 patients with renal tumors were treated with either percutaneous or laparoscopic RFA. All patients underwent preoperative imaging with contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) and were suspected to have renal cell carcinoma. The follow-up for each patient included a physical examination, chest radiography, liver function tests, and a contrast-enhanced CT or MRI. To confirm the pathologic criteria of complete ablation, 30 patients underwent 6-month or 1-year follow-up biopsy. Recurrence was defined as growth of the tumor or any new enhancing portions at 3 months after confirmed nonenhancement of the initial RFA lesion.ResultsTechnical success was achieved in 46/49 cases (94%). The mean tumor size was 2.4 cm and the mean follow-up period was 31.7 months (range, 6-68 months). Of 49 patients, repeated RFA was necessary in 7 patients (14%). Three patients were found to have recurrence at various follow-up intervals. Twenty-three patients (47%) experienced complications, and all but one necessitated intervention. No distant metastasis was found in any cases, and all patients are alive and are being serially followed up.ConclusionsPercutaneous or laparoscopic RFA is considered to be a useful treatment for selected patients with small renal masses and for nephron-sparing. With a mean follow-up of 31.7 months, our intermediate data suggest excellent therapeutic outcome with RFA with effective local tumor control and preservation of renal function. The ultimate role of this modality will continue to evolve and warrants further studies.

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“…[8] Previous studies suggest that due to increased cellular density, fewer interstitial vascular and lymphatic channels to dissipate heat and the hypoxic/acidic tumor microenvironment, tumor tissue is more sensitive than normal tissue. [9][10][11][12][13] The focus of our study was to investigate whether the rate of MWA induced apoptosis in the CNZ, TZ, and NZ increased when three different ablative powers were applied. In our three controlled experiments, we applied 50W, 70W, and 90W MWA energies directly into the porcine hepatic lesions from which we took seven biopsies each and observed cell apoptosis using M30 and Caspase-3 as immunohistochemistry markers 6 h post ablation.…”

Section: Discussionmentioning

confidence: 99%

Apoptosis Post Microwave Ablation of the Liver: Does it Change with Power?

Alzaraa¹,

McKeagney²,

Seretis³

et al. 2018

Clin J Surg

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Apoptosis is a type of the delayed or indirect cellular responses that happen after microwave ablation. It helps eradicate the few cancer cells that might survive the applied heat during cancer ablation. The extent of its expression is yet to be defined. Aims: We investigated whether the ablation power made any difference to the expression of apoptosis in the ablated and normal areas. Methods: Ablations with 50W, 70W, and 90W powers were created in three ex vivo perfused porcine livers. Biopsies were collected from the lesions and were assessed with Hematoxylin-Eosin and immunohistochemistry (Caspase 3 and M30) looking for apoptosis in each zone (central necrotic zone [CNZ], transitional zone [TZ], and normal surrounding zone [NZ]). Statistical analysis was performed using ANOVA and t-test. Results: None of the CNZ showed expression of Caspase-3. In the TZ, there was significant difference between 50W and 90W (P = 0.009), but not between 50W and 70W (P = 0.8), or between 70W and 90W (P = 0.4). In the NZ, a highly significant difference was noted between 50W and 90W (P = 0.003), a significant difference between 50W and 70W (P = 0.01), but not between 70W and 90W (P = 0.06). For M30, no expression of M30 was noted in all necrotic zones. A significant difference was noted between 50W and 90W (P = 0.02). There were no significant differences between 50W and 70W (P = 0.4) or between 70W and 90W (P = 0.07). Conclusion: Increasing power enhances apoptosis in the ablated areas. This response can be an adjunct for eradicating cancer cells that might escape the heat in the ablated zones.

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Radiofrequency Ablation and Cryoablation of Renal Tumours

Abstract: With widespread utilization of noninvasive cross-sectional abdominal imaging [...]

Cited by 29 publications

References 62 publications

Radiofrequency Ablation of Renal Tumors: Four-Year Follow-Up Results in 47 Patients

Radiofrequency Ablation of Renal Tumors: Four-Year Follow-Up Results in 47 Patients

Radiofrequency Ablation of Renal Tumors: Our Experience

Apoptosis Post Microwave Ablation of the Liver: Does it Change with Power?

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