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

Abstract

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.

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

“…Nevertheless, the contribution of a confirmatory post-RFA biopsy to the diagnosis of the reccurrence can not be ignored in patients with suspected findings of recurrence on radiological analyses. In our follow up protocol including 3 rd and 6 th month controls, it was seen that no tumor (0%) reccurrences occurred, and this result was also in correlation with the literature (Gervais et al, 2005;Park et al, 2006;Zagoria et al, 2007;Ferakis et al, 2010;del Cura et al, 2010;Kim 2012). Although RFA is a less invasive treatment than surgical treatment options, various complications, such as pain, bleeding, hematuria, infection, urinary fistula, damage of adjacent structures can be occurred in RFA (Aron and Gill, 2005;Kwan and Matsumoto, 2007;Park et al, 2009;Ji et al, 2011;Atwell et al, 2012).…”

“…It has been reported that different locations of the tumors could affect the complete ablation rates at initial RFA. Because some tumor locations, such as medial localization, adjacence to the vessels and other abdominal structures, and intraparanchimally localization, can make the clearly demonstration of the tumor, appropriately placement of RFA needle inside the tumor and sufficiently ablation of all parts of the tumor difficult (Gervais et al, 2005;Chen et al, 2009;Kim et al, 2012;Iannuccilli et al, 2012). In our study, there were 2 (16.6%) upper, 5 (41.6%) mid and 5 (41.6%) lower pole tumors.…”

“…Since more SRMs are diagnosed in elderly patients with medical comorbidities, NSS has increased perioperative risk, and the advancements occured in imaging modalities, the use of ablative treatment techniques including radiofrequency ablation (RFA) increased in the treatment of SMRs (Wingo et al, 2008;Ljungberg et al, 2010;Iannuccilli et al, 2012). These minimally invasive, more conservative and nephron-sparing treatment modalities provide some advantages, such as not requiring surgical approach and pedicule clamping, not causing transient ischemia related renal injury, shorter hospital stay, lower complication rate, and offering curative and nephron-sparing treatment to the patients who are not appropriate candidates for NSS (Matsumoto et al, 2005;Pasticier et al, 2006;Gill et al, 2007;Tracy et al, 2010;Kim et al, 2012, Laguna et al, 2012.…”

Laparoscopic Radiofrequency Ablation versus Partial Nephrectomy for cT1a Renal Tumors: Long-Term Outcome of 179 Patients

“…Ramirez et al [14] recently reported on 61 patients with RCC treated by LRFA, with a median follow-up of 59 months, the 5-year recurrence-free survival was 92%, the 5-year CSS and 5-year OS were 100 and 72%, respectively. Kim et al [11] reported on 12 patients who underwent LRFA with an 8.3% local recurrence rate at a median follow-up of 50 months.…”

“…Radiofrequency ablation (RFA) has been increasingly accepted in management of SRMs for its short learning curves, minimal invasiveness, and low complication rates [9]. The number of institutes performing renal tumor ablation has been increased, with encouraging functional and oncological results [10,11,12,13]. A majority of reports are on percutaneous RFA but laparoscopic RFA (LRFA) has also been reported.…”