Radiofrequency thermal ablation of renal graft neoplasms: A literature review

Thermoablative Treatment of De Novo Tumor in Kidney Allograft

“…9 RFA ablation of RCC is a nephron-sparring technique compared with partial transplantectomy because it avoids warm ischemia caused by vascular clamping. 20 In agreement with this, we did not find any statistically significant decrease in eGFR in the year following the thermal ablation procedure. Our results are consistent with Gul et al, who report a series of 6 patients treated by percutaneous ablation with a median creatinine level of 1.65 before ablation and 1.58 1 y after ablation.…”

“…60,61 Conservative treatment by partial surgery or percutaneous ablation should be preferred if the tumor volume, location, and transplant function allow it, according to the French recommendations of the Transplantation Committee of the French Association of Urology. 60 It can also be practiced with multiple probe-needles approaches or multiple ablative sessions in larger lesions, 20,41,43,62,63 such as in our study, with good technical success. However, partial nephrectomy, associated with better disease-free survival and local tumor progression rates, can be preferred in lesions >3 cm, 64 according to Lezzi et al 20 Active surveillance can also be a safe alternative and proposed for patients with small renal masses.…”

“…60 It can also be practiced with multiple probe-needles approaches or multiple ablative sessions in larger lesions, 20,41,43,62,63 such as in our study, with good technical success. However, partial nephrectomy, associated with better disease-free survival and local tumor progression rates, can be preferred in lesions >3 cm, 64 according to Lezzi et al 20 Active surveillance can also be a safe alternative and proposed for patients with small renal masses. Pierorazio et al found 100% cancer-specific survival in 202 patients with cT1a tumors on active surveillance.…”

“…20 Treatment choice is based on the tumor size, number, and localization of the lesions, potential extra-organ spread, and, therefore, its disease stage. 20 Renal transplantation-specific data (renal transplant life expectancy, patient access to retransplantation, and waiting times) can also guide treatment strategy. 10,55,56 The choice of the proper treatment for each patient should be based on a case-by-case discussion within a multidisciplinary tumor board composed of all the health professionals involved in the field of kidney care, such as transplant surgeons, urologists, nephrologists, oncologists, diagnostic and interventional radiologists, and pathologists.…”

“…[25][26][27][28] In nonsurgical patients, percutaneous locoregional ablative treatments such as radiofrequency thermal ablation (RFA), microwave ablation (MWA), and cryotherapy appear to be nephron conservative efficient options to destroy tumors with fewer postprocedure complications than surgery. 20 However, because of the low prevalence of de novo tumors in renal allografts, only a few case reports and small series of patients have been reported in the literature, 20 and there is no standard gold treatment for these tumors. 5 This study aims to report our center's experience of de novo tumor allograft thermoablative treatment in 19 patients (26 tumors) regarding general follow-up, postprocedure complication, and allograft function conservation.…”