Korean J Urol.  2011 Aug;52(8):531-537. 10.4111/kju.2011.52.8.531.

Radiofrequency Ablation of Renal Tumors: Our Experience

Affiliations
  • 1Department of Urology, College of Medicine, Dong-A University, Busan, Korea. sunggt@dau.ac.kr

Abstract

PURPOSE
To report our results of nephron-sparing radiofrequency ablation (RFA) of renal tumors.
MATERIALS AND METHODS
Since 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.
RESULTS
Technical 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.
CONCLUSIONS
Percutaneous 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.

Keyword

Catheter ablation; Kidney neoplasms; Minimally invasive surgical procedures

MeSH Terms

Biopsy
Carcinoma, Renal Cell
Catheter Ablation
Follow-Up Studies
Humans
Kidney Neoplasms
Liver Function Tests
Magnetic Resonance Imaging
Neoplasm Metastasis
Physical Examination
Recurrence
Surgical Procedures, Minimally Invasive
Thorax

Figure

  • FIG. 1 Well ablated, small intraparenchymal renal cell carcinoma in a 62-year-old male who underwent RFA. (A) Contrast-enhanced CT scan before RFA demonstrates a 3.3 cm solid enhancing intraparenchymal renal tumor located at the midpolar region of the right kidney. (B) Three-month follow-up contrast-enhanced CT scan demonstrates no periablation enhancement or residual contrast enhancement within the tumor bed, indicating technical success.

  • FIG. 2 A recurrent cystic RCC from the left kidney middle pole in a 63-year-old male. (A) Thirty-month follow-up contrast-enhanced CT scan shows suspicious renal cyst with enhancement, left kidney midpole. (B) One day after 2nd RFA follow-up contrast-enhanced CT scan demonstrates no periablation enhancement or residual contrast enhancement within the tumor bed.


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