Radiofrequency Ablation of Renal Tumors: Intermediate-Term Results

Park, Sangtae; Anderson, J. Kyle; Matsumoto, Edward D.; Lotan, Yair; Josephs, Shellie C.; Cadeddu, Jeffrey A.

doi:10.1089/end.2006.20.569

Cited by 128 publications

(76 citation statements)

References 14 publications

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“…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).…”

Section: Resultssupporting

confidence: 91%

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: 91%

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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“…Median length of procedure was 7.5 hours (range [4][5][6][7][8][9][10][11][12][13][14]. Sixty percent (31/51) of cases utilized renal ischemia with hilar clamping with median time of 31 (range 8-136).…”

Section: Resultsmentioning

confidence: 99%

“…Early and intermediate outcomes for ablative therapies are encouraging, yet long-term results await. 11,12 Additionally, ablative technologies may not be technically possible, ineffective, or inadvisable for tumors located in close proximity to renal vessels or intimate with the collecting system. Furthermore, experience with ablative therapy in patients with hereditary kidney cancer is limited.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Outcomes of Repeat Partial Nephrectomy

et al. 2008

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Purpose-Despite the proven efficacy of nephron sparing surgery, patients with hereditary renal cancer remain at risk for tumor recurrence. Management options for recurrent tumors include completion nephrectomy, ablation, and repeat partial nephrectomy (RPN). We examine the feasibility and outcomes of RPN performed on the same renal unit.Materials and Methods-We retrospectively reviewed the records of 51 attempted RPN cases on 47 patients from 1992 to 2006. Demographic information as well as intraoperative, perioperative, and renal functional outcome data were collected. Comparison of pre-and postoperative renal function was performed using the two tailed T-test.Results-Major perioperative complications or reoperations occurred in 10 of 51 (19.6%) cases that included one perioperative mortality (1.9%). In cases of successful RPN, there was a statistically significant increase in postoperative serum creatinine (1.35 vs. 1.16 mg/dL, p <0.05) and a significant decrease in creatinine clearance (84.6 mL/min vs. 95.3mL/min, p = 0.05) and renogram split function (52.3% vs. 54.8%, p <0.05). Two patients required long term hemodialysis (3.9%). Ten of the 51 renal units (19.6%) in our study required subsequent operations for additional local recurrence or de novo tumor formations with a median time to subsequent surgery of 50 months. Forty-six of fortyseven patients are alive at median follow up of 56 months.Conclusions-RPN is technically feasible. Although there is a statistically significant decrease in postoperative renal functional studies, most patients retained sufficient function to avoid hemodialysis. RPN may provide acceptable oncologic control despite the anticipated development of locally recurrent or de novo tumors. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. While repeat partial nephrectomy may maintain the balance between tumor control and renal preservation, the feasibility as well as functional and oncologic outcomes of patients undergoing RPN are not well established. There are a few reports of patients with hereditary kidney cancer that have undergone repeat NSS. [4][5][6] However, most of these series report limited numbers which may restrict the ability to make conclusions regarding repeat partial nephrectomy. Our ongoing clinical experience in patients with hereditary kidney cancer who are at risk for metachronous tumor formation has provided a unique opportunity to evaluate the feasibility and outcomes of repeat partial nephrectomy. Keywords NIH Public Access MATERIALS AND METHODSBetween 1992 and 2006, 51 cases of planned RPN on the same renal unit ...

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“…Several recent studies have reported recurrence rates of less than 10% and excellent disease-specific survival rates of 95% to 100% in patients treated with thermal ablation. [42][43][44][45][46][47][48][49][50][51][52][53] Recent multiinstitutional reviews noted recurrent or residual disease in 3.9% to 5.2% of cryoablation patients and 12.9% to 13.4% in RFA patients. These numbers are difficult to compare, as significantly more patients had cryotherapy performed via laparoscopy and RFA was performed percutaneously.…”

Section: Thermal Ablation Therapies In Small Renal Massesmentioning

confidence: 99%

Recent developments in kidney cancer

Leveridge

Jewett

2013

CUAJ

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Renal cell carcinoma (RCC) diagnosis and management have undergone significant shifts in the recent past. The increasing rate of diagnosis of small renal masses, often in patients at high risk of morbidity with operative treatment, has led to studies, trials and discoveries in renal mass biopsy, active surveillance and minimally invasive thermal ablation. At the other end of the disease spectrum, targeted systemic therapies for metastatic RCC have supplanted cytokine-based treatment, with significant benefits to progression and survival. Recent reviews and trials have also cemented the role of partial nephrectomy as standard surgical management for most low-stage masses, and the roles of regional lymphadenectomy and adrenalectomy concomitant with nephrectomy have been clarified. This review aims to highlight recent evidence that has emerged in the management of this complicated oncologic issue. RésuméLe diagnostic d'hypernéphrome et la prise en charge de cette maladie ont fait l'objet d'importants changements au cours des dernières années. Le taux accru de cas de petites masses rénales, souvent chez des patients présentant un risque élevé de morbidité avec le traitement chirurgical, a amené la conduite d'études et d'essais qui ont entraîné des découvertes touchant la biopsie des masses rénales, la surveillance active et l'ablation thermique minimalement invasive. À l'autre bout du spectre pathologique, les traitements généraux ciblés de l'hypernéphrome métastatique ont supplanté le traitement à base de cytokines, ce qui a amené des avantages significatifs sur le plan de la progression et de la survie. Des articles de synthèse et des essais récents ont aussi confirmé le rôle de la néphrectomie partielle en tant que prise en charge chirurgicale standard pour la plupart des masses de faible stade, et les rôles de la lymphadénectomie régionale et de la surrénalec-tomie en concomitance avec une néphrectomie ont été clarifiés. Le présent article vise à faire ressortir les données récentes dans la prise en charge de ce problème oncologique complexe. IntroductionThe Canadian Cancer Society and the National Cancer Institute of Canada predict 4800 new kidney cancer diagnoses in 2010, and 1650 Canadian deaths from the disease. Kidney cancer is the most lethal genitourinary cancer, but is also among the most interesting cancers due to recent developments exploiting knowledge about known genetic mutations with targeted systemic therapies, better understanding of the extent of associated chronic kidney disease, the utility of nephron-sparing surgery when treating primary tumours and the significant advances in less invasive therapies.This review is not intended to be an exhaustive assessment of the present state of knowledge of kidney cancer, but is an update on recent clinically relevant developments. Diagnosis and stagingOverall, about 85% of renal masses, presumed to be kidney cancers on imaging studies, are carcinomas at nephrectomy. 2Due in part to this high incidence of cancer, biopsy has not been recommended in...

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Radiofrequency Ablation of Renal Tumors: Intermediate-Term Results

Abstract: In the intermediate term (1-4 years), the oncologic effectiveness of RFA appears comparable to that of traditional treatments offered for small renal masses. Further studies of larger numbers of patients with longer follow-up are needed.

Cited by 128 publications

References 14 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

Feasibility and Outcomes of Repeat Partial Nephrectomy

Recent developments in kidney cancer

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