Department of Urology, Amrita Institute of Medical Sciences, Kochi, India
Department of Urology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
Department of Urology, Amrita Institute of Medical Sciences, Kochi, India
Department of Urology, Amrita Institute of Medical Sciences, Kochi, India
Department of Urology, Amrita Institute of Medical Sciences, Kochi, India
radiofrequency ablation, small renal mass, Kidney, cancer, Postoperative complications
AbstractOur study aims to discern the immediate and intermediate-term oncological outcomes of the patients with small renal mass and who were surgically unfit or were having a bilateral tumor and underwent radiofrequency ablation (RFA) of the mass. We retrospectively and prospectively analyzed the status of the patients who were diagnosed to have small renal masses and were biopsy-proven renal cell carcinoma (RCC) cases, who underwent RFA at our institute from the year 2013 to 2022. Patients were followed-up for 3 years. Data regarding complications were analyzed for all patients who underwent renal RFA along with the 3-year recurrence-free survival (RFS) rate. A total of 28 patients were eligible for the study based on our inclusion and exclusion criteria. Their renal function was recorded. They underwent RFA and were followed-up for a period of 3 years for RFS. Four patients out of the total had immediate complications, out of which two developed a hematoma. Three-year-follow-ups showed six recurrences, overall having 78.6% RFS. Post-procedural renal function was stable as documented by estimated glomerular filtration rate. Oncological results of RFA in patients with small renal masses who are surgically unfit are associated with a low risk of immediate and intermediate-term deterioration of renal function.
References
1. MacLennan S, Imamura M, Lapitan MC, Omar MI, Lam TB, Hilvano-Cabungcal AM, et al. Systematic review of oncological outcomes following surgical management of localised renal cancer. Eur Urol. 2012 May;61(5):972–93. http://dx.doi.org/10.1016/j.eururo.2012.02.039. Erratum in: Eur Urol. 2012 Jul;62(1):193.
2. 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(2):177–181. http://dx.doi.org/10.1016/j.ajur.2021.10.003
3. Bosniak MA, Birnbaum BA, Krinsky GA, Waisman J. Small renal parenchymal neoplasms: Further observations on growth. Radiology. 1995 Dec;197(3):589–97. http://dx.doi.org/10.1148/radiology.197.3.7480724
4. Curry D, Pahuja A, Loan W, Thwaini A. Radiofrequency ablation of small renal masses: Outcomes, complications and effects on renal function. Curr Urol. 2018 Jun;11(4):196–200. http://dx.doi.org/10.1159/000447218
5. Zhong J, Wah TM. Renal ablation: Current management strategies and controversies. Chin Clin Oncol. 2019;8:63. http://dx.doi.org/10.21037/cco.2019.12.08
6. Pantelidou M, Challacombe B, McGrath A, Brown M, Ilyas S, Katsanos K, et al. Percutaneous radiofrequency ablation versus robotic-assisted partial nephrectomy for the treatment of small renal cell carcinoma. Cardiovasc Intervent Radiol. 2016;39:1595–603. http://dx.doi.org/10.1007/s00270-016-1417-z
7. Olweny EOF, Park SK, Tan YK, Best SL, Trimmer C, Cadeddu JA. Radiofrequency ablation versus partial nephrectomy in patients with solitary clinical T1a renal cell carcinoma: Comparable oncologic outcomes at a minimum of 5 years of followup. Eur Urol. 2012;61:1156–61. http://dx.doi.org/10.1016/j.eururo.2012.01.001
8. Whitson JM, Harris CR, Meng MV. Population-based comparative effectiveness of nephron-sparing surgery vs. ablation for small renal masses. BJU Int. 2012;110:1438–43. http://dx.doi.org/10.1111/j.1464-410X.2012.11113.x
9. Iannuccilli JD, Dupuy DE, Beland MD, Machan JT, Golijanin DJ, Mayo-Smith WW. Effectiveness and safety of computed tomography-guided radiofrequency ablation of renal cancer: A 14-year single institution experience in 203 patients. Eur Radiol. 2016;26:1656–64. http://dx.doi.org/10.1007/s00330-015-4006-7
10. Johnson DB, Taylor GD, Lotan Y, Sagalowsky AI, Koenemann KS, Cadeddu JA. The effects of radio frequency ablation on renal function and blood pressure. J Urol. 2003 Dec;170(6 Pt 1):2234–6. http://dx.doi.org/10.1097/01.ju.0000096265.22657.e8
11. Psutka SP, Feldman AS, McDougal WS, McGovern FJ, Mueller P, Gervais DA. Long-term oncologic outcomes after radiofrequency ablation for T1 renal cell carcinoma. Eur Urol. 2013 Mar;63(3):486–92. http://dx.doi.org/10.1016/j.eururo.2012.08.062
12. Lucas SM, Stern JM, Adibi M, Zeltser IS, Cadeddu JA, Raj GV. Renal function outcomes in patients treated for renal masses smaller than 4 cm by ablative and extirpative techniques. J Urol. 2008 Jan;179(1):75–9; discussion 79–80. http://dx.doi.org/10.1016/j.juro.2007.08.156
13. Johnson DB, Solomon SB, Su LM, et al. Defining the complications of cryoablation and radio frequency ablation of small renal tumors: A multi-institutional review. J Urol. 2004;172(3):874–7. http://dx.doi.org/10.1097/01.ju.0000135833.67906.ec
14. Hui GC, Tuncali K, Tatli S, Morrison PR, Silverman SG. Comparison of percutaneous and surgical approaches to renal tumor ablation: Meta-analysis of effectiveness and complication rates. J Vasc Interv Radiol. 2008;19(9):1311–20. http://dx.doi.org/10.1016/j.jvir.2008.05.014
15. Kurup AN. Percutaneous ablation for small renal masses-complications. Semin Intervent Radiol. 2014 Mar;31(1):42–9. http://dx.doi.org/10.1055/s-0033-1363842
16. Hwang JJ, Walther MM, Pautler SE, Coleman JA, Hvizda J, Peterson J, et al. Radio frequency ablation of small renal tumors: Intermediate results. J Urol. 2004;171(5):1814–18. http://dx.doi.org/10.1097/01.ju.0000119905.72574.de
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