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

Abstract

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.

Tubulocystic Renal Cell Carcinoma Is Not an Indolent Tumor: A Case Report of Recurrences in the Retroperitoneum and Contralateral Kidney

“…For locally recurrent or oligometastatic RCC, metastasectomy, stereotactic body radiation therapy, or ablative treatment should be considered according to the National Comprehensive Cancer Network guidelines [ 20 ]. RFA is an appropriate treatment option for small RCC with durable onco-logical outcomes of 94–96.1% disease-free survival and low complication rates [ 21 , 22 ]. Integrated with a systemic treatment strategy, RFA is safe and effective for the treatment of metastatic disease from RCC with good overall survival and long systemic treatment-free survival [ 23 ].…”

Assessment of the effectiveness of radiofrequency ablation as a technique for destroying small renal tumors in patients older than 70

“…Psutka SP et al, 2013, also reported high disease-free rates of up to 92.3% in patients with RCC T1a after RFA at 3.8-year median follow-up with a median tumor size of 3 cm (IQR: 2.1–3.9 cm) [ 30 ]. The significant advantage of RFA in RCC patients is its minimal influence on renal function that is extremely important in the elderly [ 31 ]. Our study also confirms the absence of renal function impairment after treatment with RFA or TE.…”

Long-term oncological outcomes for radiofrequency ablation of small renal masses

“…Part of this cohort has previously been described with short-term outcomes (median follow-up 29 months) from RFA. 5…”

“…Procedure protocol and technique has previously been described. 5 All cases were performed percutaneously under local anaesthetic and intravenous sedation. Biopsy was performed through a coaxial sheath concomitantly with ablation.…”