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Al-Zubaidi M, Lotter K, Marshall M, Lozinskiy M. Radiofrequency ablation for renal tumours: A retrospective study from a tertiary centre. Asian J Urol 2023; 10:177-181. [PMID: 36942114 PMCID: PMC10023533 DOI: 10.1016/j.ajur.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 04/05/2021] [Accepted: 07/02/2021] [Indexed: 11/19/2022] Open
Abstract
Objective This study aimed to evaluate the safety and efficacy outcomes of percutaneous radiofrequency ablation (RFA) for localised renal cell carcinoma (RCC) in a tertiary hospital patient who remained unfit for surgical intervention. Methods We retrospectively analysed survival outcomes for patients with biopsy proven RCC treated by RFA at Royal Perth Hospital between September 2009 and May 2018. Complication data were gathered for all patients that underwent renal RFA along with 2- and 5-year recurrence-free survival (RFS) rate and compared the outcomes with data from previous studies. Results A total of 69 patients (73 procedures) were eligible for the study, and those patients had biopsy-proven RCC with a minimum of 2-year follow-up. The complication rate was 8.2% (6/73) and local recurrence rate 9.6% (7/73). Two-year RFS is 95.7% and 5-year RFS is 78.8% on a median 3.82-year follow-up (interquartile range 1.90-5.75 years). Conclusion RFA performed at our centre was found to be safe and effective with low complication rates and durable RFS in line with expectations from existing research. Our study demonstrated that RFA is an alternative modality of treatment for small renal tumours in patients unfit for surgical approach.
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Affiliation(s)
- Mohammed Al-Zubaidi
- Department of Urology, Royal Perth Hospital, Perth, Australia
- Corresponding author.
| | - Kennia Lotter
- Department of Urology, Royal Perth Hospital, Perth, Australia
| | - Martin Marshall
- Department of Radiology, Royal Perth Hospital, Perth, Australia
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Gümüş BH, Albaz AC, Düzgün F, Üçer O, Temeltaş G, Müezzinoğlu T, Tarhan S. Long term follow-up results of ablation treatment for patients with small renal mass. Int J Clin Pract 2021; 75:e14130. [PMID: 33660394 DOI: 10.1111/ijcp.14130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/26/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE The aim of this study is to evaluate the outcome of ablation therapy in our clinic for the treatment of patients with a small renal mass Materials and Methods: We retrospectively evaluated the technic and follow-up data of 30 patients with 36 tumours who underwent Radiofrequency Ablation (RFA) and Microwave Ablation (MWA) in our clinic. Demographic data, ablation type, tumour characteristics, peroperative and postoperative complications and treatment success of the patients were evaluated. RESULTS A total of 36 tumours who underwent ablation treatments, 23 were treated with RFA, 13 with MWA. The mean tumour size was 28.9 ± 6.92 mm in RFA and 29.3 ± 7.70 mm in MWA. The mean follow-up period was 49.6 ± 24.7 months in patients with RFA and mean follow-up was 16 ± 8.05 months in MWA treatments. The overall success in MWA administration was calculated as 76.9%, while the overall success in RFA was 80%. CONCLUSION Long-term oncologic efficacy of RFA appears to be successful in the treatment of T1a renal carcinomas. Further studies can be conducted to elucidate the influence of MWA on long-term oncological outcomes.
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Affiliation(s)
- Bilali Habeş Gümüş
- Department of Urology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Ali Can Albaz
- Department of Urology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Fatih Düzgün
- Department of Radiology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Oktay Üçer
- Department of Urology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Gökhan Temeltaş
- Department of Urology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Talha Müezzinoğlu
- Department of Urology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Serdar Tarhan
- Department of Radiology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
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Tsili AC, Andriotis E, Gkeli MG, Krokidis M, Stasinopoulou M, Varkarakis IM, Moulopoulos LA. The role of imaging in the management of renal masses. Eur J Radiol 2021; 141:109777. [PMID: 34020173 DOI: 10.1016/j.ejrad.2021.109777] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/09/2021] [Accepted: 05/14/2021] [Indexed: 12/26/2022]
Abstract
The wide availability of cross-sectional imaging is responsible for the increased detection of small, usually asymptomatic renal masses. More than 50 % of renal cell carcinomas (RCCs) represent incidental findings on noninvasive imaging. Multimodality imaging, including conventional US, contrast-enhanced US (CEUS), CT and multiparametric MRI (mpMRI) is pivotal in diagnosing and characterizing a renal mass, but also provides information regarding its prognosis, therapeutic management, and follow-up. In this review, imaging data for renal masses that urologists need for accurate treatment planning will be discussed. The role of US, CEUS, CT and mpMRI in the detection and characterization of renal masses, RCC staging and follow-up of surgically treated or untreated localized RCC will be presented. The role of percutaneous image-guided ablation in the management of RCC will be also reviewed.
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Affiliation(s)
- Athina C Tsili
- Department of Clinical Radiology, School of Health Sciences, Faculty of Medicine, University of Ioannina, 45110, Ioannina, Greece.
| | - Efthimios Andriotis
- Department of Newer Imaging Methods of Tomography, General Anti-Cancer Hospital Agios Savvas, 11522, Athens, Greece.
| | - Myrsini G Gkeli
- 1st Department of Radiology, General Anti-Cancer Hospital Agios Savvas, 11522, Athens, Greece.
| | - Miltiadis Krokidis
- 1st Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Areteion Hospital, 11528, Athens, Greece; Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital Bern University Hospital, University of Bern, 3010, Bern, Switzerland.
| | - Myrsini Stasinopoulou
- Department of Newer Imaging Methods of Tomography, General Anti-Cancer Hospital Agios Savvas, 11522, Athens, Greece.
| | - Ioannis M Varkarakis
- 2nd Department of Urology, National and Kapodistrian University of Athens, Sismanoglio Hospital, 15126, Athens, Greece.
| | - Lia-Angela Moulopoulos
- 1st Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Areteion Hospital, 11528, Athens, Greece.
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Bersang AB, Søndergaard Mosholt KS, Verner Jensen C, Germer U, Holm M, Røder MA. Safety and oncological outcome following radiofrequency ablation of small renal masses in a single center. Scand J Urol 2021; 55:203-208. [PMID: 33739218 DOI: 10.1080/21681805.2021.1900386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To evaluate the safety and efficacy of percutaneous CT-guided radiofrequency ablation (RFA) for small renal masses (SRMs) at a large single-institution center during a period of 12 years. MATERIALS AND METHODS A total of 118 patients underwent RFA for SRM between July 2006 and July 2018 at our institution. We included demographic information, comorbidity, procedural details, and oncological outcome in the analysis. Survival analysis was performed using competing risk. RESULTS 87 males and 31 females with median age 66 years underwent RFA. Median tumor size was 23 mm. Tumor biopsy was performed in 94% of cases, of which 56% were confirmed renal cell carcinoma (RCCs). Twenty-eight patients had benign tumors or underwent treatment for recurrence of prior RCC. Median follow-up of 5 years. Median Charlson Comorbidity Index was 5. Major complications occurred in 1.7%. No change in kidney function was observed. The initial treatment response was 98%. Among patients treated for newly diagnosed radiological suspected RCC without Von Hippel-Lindau or benign biopsy (90 pts), the cumulative incidence of radiological recurrence after 5 and 10 years was 6.6% (95% CI: 0.8-12%) and 16% (95% CI: 4.2-28%), respectively. Three patients died of RCC during follow-up. The cumulative incidence of kidney cancer death was 4.5% (95% CI: 4.3-13%) after 10 years. The incidence of other-cause mortality was 50% (95% CI: 34-67%). CONCLUSION CT-guided RFA is a safe and effective treatment option for patients unsuitable for surgery. RFA is a good alternative to partial or radical nephrectomy for SRMs, although randomized trials comparing surgery to minimally invasive thermal ablation techniques are missing.
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Affiliation(s)
- Ann Buhl Bersang
- Urological Research Unit, Department of Urology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Karina Sif Søndergaard Mosholt
- Urological Research Unit, Department of Urology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Claus Verner Jensen
- Department of Radiology, Centre of Diagnostic Investigations, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Ulla Germer
- Department of Radiology, Centre of Diagnostic Investigations, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Mette Holm
- Urological Research Unit, Department of Urology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Martin Andreas Røder
- Urological Research Unit, Department of Urology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Percutaneous image-guided renal ablations: Current evidences for long-term oncologic efficacy. Presse Med 2019; 48:e233-e243. [PMID: 31445699 DOI: 10.1016/j.lpm.2019.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 04/24/2019] [Accepted: 07/17/2019] [Indexed: 01/20/2023] Open
Abstract
The rise in incidentally discovered small renal neoplasms has focused attention on nephron-sparing treatment strategies including partial nephrectomy and percutaneous ablation as well as active surveillance. As all treatment modality, renal ablation has matured technically. Radiofrequency ablation, microwave ablation or cryoablation are now performed in many institutions under imaging guidance. The long-term results allow them to be now recommended as a therapeutic option whatever the patients' condition if complete ablation can reliably be achieved.
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Acosta Ruiz V, Lönnemark M, Brekkan E, Dahlman P, Wernroth L, Magnusson A. Predictive factors for complete renal tumor ablation using RFA. Acta Radiol 2016; 57:886-93. [PMID: 26452975 DOI: 10.1177/0284185115605681] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 08/02/2015] [Indexed: 01/20/2023]
Abstract
BACKGROUND Radiofrequency ablation (RFA) can be used to treat renal masses in patients where surgery is preferably avoided. As tumor size and location can affect ablation results, procedural planning needs to identify these factors to limit treatment to a single session and increase ablation success. PURPOSE To identify factors that may affect the primary efficacy of complete renal tumor ablation with radiofrequency after a single session. MATERIAL AND METHODS Percutaneous RFA (using an impedance based system) was performed using computed tomography (CT) guidance. Fifty-two renal tumors (in 44 patients) were retrospectively studied (median follow-up, 7 months). Data collection included patient demographics, tumor data (modified Renal Nephrometry Score, histopathological diagnosis), RFA treatment data (electrode placement), and follow-up results (tumor relapse). Data were analyzed through generalized estimating equations. RESULTS Primary efficacy rate was 83%. Predictors for complete ablation were optimal electrode placement (P = 0.002, OR = 16.67) and increasing distance to the collecting system (P = 0.02, OR = 1.18). Tumor size was not a predictor for complete ablation (median size, 24 mm; P = 0.069, OR = 0.47), but all tumors ≤2 cm were completely ablated. All papillary tumors and oncocytomas were completely ablated in a single session; the most common incompletely ablated tumor type was clear cell carcinoma (6 of 9). CONCLUSION Optimal electrode placement and a long distance from the collecting system are associated with an increased primary efficacy of renal tumor RFA. These variables need to be considered to increase primary ablation success. Further studies are needed to evaluate the effect of RFA on histopathologically different renal tumors.
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Affiliation(s)
| | - Maria Lönnemark
- Department of Radiology, University Hospital, Uppsala, Sweden
| | - Einar Brekkan
- Department of Urology, University Hospital, Uppsala, Sweden
| | - Pär Dahlman
- Department of Radiology, University Hospital, Uppsala, Sweden
| | - Lisa Wernroth
- Department of Medical Sciences, Molecular Epidemiology, University Hospital, Uppsala, Sweden
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Gobara H, Hiraki T, Iguchi T, Fujiwara H, Nasu Y, Kanazawa S. Percutaneous CT-guided Radiofrequency Ablation for Renal Cell Carcinoma in von Hippel-Lindau Disease: Midterm Results. ACTA ACUST UNITED AC 2016. [DOI: 10.22575/interventionalradiology.1.1_1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Hideo Gobara
- Department of Radiology, Okayama University Medical School
| | - Takao Hiraki
- Department of Radiology, Okayama University Medical School
| | | | | | - Yasutomo Nasu
- Department of Urology, Okayama University Medical School
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Les traitements ablatifs dans le cancer du rein localisé : revue de la littérature en 2014. Prog Urol 2015; 25:499-509. [DOI: 10.1016/j.purol.2015.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 04/27/2015] [Accepted: 04/29/2015] [Indexed: 01/25/2023]
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Yuksel MB, Karakose A, Gumus B, Tarhan S, Atesci YZ, Akan Z. 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. Asian Pac J Cancer Prev 2014; 14:6637-41. [PMID: 24377580 DOI: 10.7314/apjcp.2013.14.11.6637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the results of various types of radiofrequency ablation (RFA) treatment of renal tumors in patients with excessive anesthetic and surgical risk. MATERIALS AND METHODS Data for RFA performed in in high risk patients were retrospectively evaluated. Other RFA applications in patients with no anesthetic and/or surgical risk were excluded. RFA was by ultrasound or CT guided percutaneous (USG/CT-PRFA) and retroperitoneally or transperitoneally laparoscopic (R/T-LRFA) techniques under general or local anethesia. Follow-up data of enhanced CT or MRI after 1, 3 and 6 months were analysed for twelve RFA applications. RESULTS The RFA applications included 4 (40%) left-sided, 5 (50%) right-sided and 1 (10%) bilaterally RFA (simultaneously 1 right and 2 left). The localizations of tumors were 2 (16.6%) upper, 5 (41.6%) mid and 5 (41.6%) lower pole. The RFA applications included 9 (75%) USG-PRFA, 1 (8.3%) CT-PRFA, 1 (8.3%) T-LRFA and 1 (8.3%) R-LRFA. The mean age was 65.3 ± 8.5 (52-76) years. The mean tumor size was 29.6 ± 6.08 (15-40) mm. No complications related to the RFA were encountered in any of the cases. Failure (residual tumour) was determined in 8.3% (1/12) of USG-RFA application. The success rate was thus 91.7% (11/12). Other 1st, 3rd and 6th months follow-up data revealed no residua and recurrence. CONCLUSIONS RFA application appears to be safe as a less invasive and effective treatment modality in selected cases of small renal tumors in individuals with excessive anesthetic and also surgical risk.
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Affiliation(s)
- Mehmet Bilgehan Yuksel
- Department of Urology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey E-mail :
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Youn CS, Park JM, Lee JY, Song KH, Na YG, Sul CK, Lim JS. Comparison of laparoscopic radiofrequency ablation and open partial nephrectomy in patients with a small renal mass. Korean J Urol 2013; 54:603-8. [PMID: 24044094 PMCID: PMC3773590 DOI: 10.4111/kju.2013.54.9.603] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 06/26/2013] [Indexed: 01/01/2023] Open
Abstract
Purpose We have performed both open partial nephrectomy (OPN) and laparoscopic radiofrequency ablation (RFA) on selected patients since January 2007 and have been following these patients through serial laboratory assessments and computed tomography (CT). The purpose of the present study was to evaluate long-term oncologic outcomes and renal function status for laparoscopic RFA versus OPN at a minimum follow-up of 3 years. Materials and Methods A total of 55 patients with exophytic, single small renal masses were treated with either OPN (n=14) or laparoscopic RFA (n=41) by a single surgeon. The indications for laparoscopic RFA were as follows: 1) cases with the greatest dimension of the renal mass <3 cm, and 2) cases in which the collecting system, renal calyx, and great vessels were free from the tumor margins by 1 cm. Results The estimated blood loss (EBL), the operation time, and the mean number of hospital days was significantly lower in the laparoscopic RFA group than in the OPN group. Oncologic data did not differ significantly between the two groups. Creatine clearance levels did not differ significantly compared with those before the operation in either group. Conclusions Our data suggest excellent therapeutic outcomes with laparoscopic RFA with achievement of effective operative times, hospital stays, and EBL compared with OPN. According to our indications for laparoscopic RFA, laparoscopic RFA is an effective minimally invasive therapy for the treatment of small renal masses, yielding oncologic outcomes and renal function equivalent to those of OPN.
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Affiliation(s)
- Chang Shik Youn
- Department of Urology, Chungnam National University School of Medicine, Daejeon, Korea
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Krokidis M, Spiliopoulos S, Jarzabek M, Fotiadis N, Sabharwal T, O'Brien T, Adam A. Percutaneous radiofrequency ablation of small renal tumours in patients with a single functioning kidney: long-term results. Eur Radiol 2013; 23:1933-9. [PMID: 23475163 DOI: 10.1007/s00330-013-2802-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 01/08/2013] [Accepted: 01/14/2013] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To evaluate the long-term results of percutaneous radiofrequency ablation (RFA) of small renal tumours in patients with a single functioning kidney (SFK). METHODS This is a single-centre prospective study. Patients with an SFK and a tumour smaller than 3.5 cm, treated with RFA over a 7.5-year period, were included. Nineteen consecutive patients (12 male), aged between 33 and 83 years (mean 61.4), were treated for 23 lesions. Primary endpoints were technical success and tumour recurrence rate. Secondary endpoints were the deterioration of renal function and overall survival rate. RESULTS The mean follow-up was 56.1 months (range 36-102). Primary technical success was 100 %. There were no major peri-procedural complications. In two cases, minor complications occurred. There was no significant difference between the baseline glomerular filtration rate (GFR) and GFR at 3, 12 and 24 months post-procedure. In four lesions (17 %), recurrence was detected and an additional RFA session was performed. None of the patients developed renal failure during their lifetime. Three of the patients died because of other reasons. CONCLUSIONS Percutaneous RFA of small renal tumours in patients with an SFK offers very satisfactory long-term results regarding preservation of renal function, local tumour control and overall survival. KEY POINTS • Tumour in a single functioning kidney requires minimally invasive treatment. • Radiofrequency ablation plays an established role in managing small renal tumours. • Long-term results of radiofrequency ablation have shown satisfactory local tumour control. • Long-term results have also shown that renal function may be preserved.
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Affiliation(s)
- Miltiadis Krokidis
- Department of Radiology, Guy's and St Thomas' Hospitals NHS Foundation Trust, 1st Floor Lambeth Wing, Westminster Bridge Road, SE1 7EH, London, UK.
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Arnoux V, Descotes JL, Sengel C, Terrier N, Rambeaud JJ, Long JA. Traitement d’une tumeur rénale et préservation néphronique impérative : étude comparative des données périopératoires et des résultats à moyen terme de la néphrectomie partielle et de la radiofréquence. Prog Urol 2013; 23:99-104. [DOI: 10.1016/j.purol.2012.08.269] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 08/17/2012] [Accepted: 08/17/2012] [Indexed: 01/20/2023]
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Kim SD, Yoon SG, Sung GT. Radiofrequency ablation of renal tumors: four-year follow-up results in 47 patients. Korean J Radiol 2012; 13:625-33. [PMID: 22977331 PMCID: PMC3435861 DOI: 10.3348/kjr.2012.13.5.625] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Accepted: 03/20/2012] [Indexed: 11/25/2022] Open
Abstract
Objective To retrospectively evaluate the intermediate results of radiofrequency ablation (RFA) of small renal masses (SRMs). Materials and Methods Percutaneous 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. Results Technical 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. Conclusion RFA 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.
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Affiliation(s)
- Soo Dong Kim
- Department of Urology, Dong-A University College of Medicine, Busan 602-714, Korea
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Cornelis F, Balageas P, Le Bras Y, Rigou G, Boutault JR, Bouzgarrou M, Grenier N. Radiologically-guided thermal ablation of renal tumours. Diagn Interv Imaging 2012; 93:246-61. [DOI: 10.1016/j.diii.2012.02.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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15
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Grasso RF, Luppi G, Faiella E, Giurazza F, Del Vescovo R, Cazzato RL, Beomonte Zobel B. Radiofrequency ablation of renal cell carcinoma in patients with a solitary kidney: a retrospective analysis of our experience. Radiol Med 2011; 117:606-15. [DOI: 10.1007/s11547-011-0758-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 06/10/2011] [Indexed: 01/29/2023]
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Kim JH, Kim TH, Kim SD, Lee KS, Sung GT. Radiofrequency ablation of renal tumors: our experience. Korean J Urol 2011; 52:531-7. [PMID: 21927699 PMCID: PMC3162218 DOI: 10.4111/kju.2011.52.8.531] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Accepted: 06/16/2011] [Indexed: 12/02/2022] Open
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.
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Affiliation(s)
- Jeong Ho Kim
- Department of Urology, College of Medicine, Dong-A University, Busan, Korea
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Patard JJ, Baumert H, Corréas JM, Escudier B, Lang H, Long JA, Neuzillet Y, Paparel P, Poissonnier L, Rioux-Leclercq N, Soulié M. Recommandations en Onco-Urologie 2010 : Cancer du rein. Prog Urol 2010; 20 Suppl 4:S319-39. [DOI: 10.1016/s1166-7087(10)70048-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Lucas SM, Cadeddu JA. The importance of nephron-sparing focal therapy: renal function preservation. J Endourol 2010; 24:769-74. [PMID: 20370438 DOI: 10.1089/end.2009.0442] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Historically, renal cancer has been treated with radical nephrectomy. Consequently, many patients developed renal insufficiency and the health problems associated with this. With the increasing diagnosis of small renal masses, nephron-sparing treatments have been developed to treat these masses adequately, while maximizing renal function. Focal ablative therapy is a means to treat small renal masses in a minimally invasive manner. Yet, there are few studies that have focused on their ability to preserve renal function. In this article, we review the existing literature on the renal function outcomes of patients treated with either radio frequency ablation or cryoablation.
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Affiliation(s)
- Steven M Lucas
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9110, USA
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Radiofrequency ablation of kidney tumours in patients with a solitary kidney. Clin Radiol 2010; 65:230-6. [PMID: 20152280 DOI: 10.1016/j.crad.2009.11.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Revised: 10/23/2009] [Accepted: 11/02/2009] [Indexed: 12/20/2022]
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Long JA, Neuzillet Y, Poissonnier L, Lang H, Paparel P, Escudier B, Rioux-Leclercq N, Correas JM, Mejean A, Baumert H, Soulié M, Patard JJ. Les traitements ablatifs modifient-ils la prise en charge des tumeurs du rein chez la personne âgée ? Prog Urol 2009; 19 Suppl 3:S116-23. [DOI: 10.1016/s1166-7087(09)73356-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hiraoka K, Kawauchi A, Nakamura T, Soh J, Mikami K, Miki T. Radiofrequency ablation for renal tumors: our experience. Int J Urol 2009; 16:869-73. [PMID: 19735313 DOI: 10.1111/j.1442-2042.2009.02378.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To report our results of percutaneous radiofrequency ablation (RFA) for renal tumors and to assess predictors of therapeutic efficacy. METHODS Forty patients (median age 73 years) with renal tumors were treated with RFA under local or epidural anesthesia. All of them had high surgical risk or refused radical surgery. Tumors were punctured percutaneously using the Radionics Cool-tip RF System under computed tomography or ultrasonographic guidance. Median tumor diameter was 24 mm. After RFA, contrast-enhanced computed tomography or magnetic resonance imaging was performed within 1 month. Complete response (CR) was defined as no enhancement inside the tumor. Factors related to the outcome and to renal function were assessed. RESULTS Median follow up was 16 months. CR was observed in 34 cases (85.0%). A significant difference in CR rate was observed between tumors < or =30 mm and those >30 mm. Outcomes tended to be better for tumors in the mid to lower kidney, and those away from the renal hilum. Recurrence was observed in one case (2.9%), but a CR was obtained again by additional RFA. Out of a total of 77 RFA procedures, complications occurred in only three cases (3.9%), and conservative treatment was possible in all cases. Serum creatinine levels 3 months after RFA did not differ from those before RFA. CONCLUSIONS Percutaneous RFA is a safe and effective treatment for small renal tumors in patients with high surgical risk or who refuse radical surgery.
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Affiliation(s)
- Kenji Hiraoka
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
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Kawamoto S, Solomon SB, Bluemke DA, Fishman EK. Computed tomography and magnetic resonance imaging appearance of renal neoplasms after radiofrequency ablation and cryoablation. Semin Ultrasound CT MR 2009; 30:67-77. [PMID: 19358438 DOI: 10.1053/j.sult.2008.12.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Thermal ablation procedures including radiofrequency ablation and cryoablation have been increasingly used for treatment for small renal cell carcinoma. Currently, computed tomography and magnetic resonance imaging are usually used to assess residual or recurrent disease after thermal ablation of renal tumor. After thermal ablation, the zone of ablation is usually seen as an area of hypoattenuation on computed tomography and is generally hypointense at T2-weighted magnetic resonance imaging and iso- to hyperintense at T1-weighted imaging relative to renal parenchyma. The ablation zone frequently involutes over time. Residual tumor after thermal ablation is most common at the margin of the ablation zone and often seen as nodular or crescent-shaped areas of contrast enhancement. Accurate assessment of ablated tumors at postprocedural imaging is essential for evaluating the adequacy of treatment and guiding further management. Complications are uncommon and usually minor but should be detected on postprocedural imaging studies.
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Affiliation(s)
- Satomi Kawamoto
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
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