Korean Journal of Radiology

  • 제13권5호
  • /
  • Pages.625-633
  • /
  • 2012
  • /
  • 1229-6929(pISSN)
  • /
  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지
DOI QR코드

DOI QR Code

Radiofrequency Ablation of Renal Tumors: Four-Year Follow-Up Results in 47 Patients

  • Kim, Soo Dong (Department of Urology, Dong-A University College of Medicine) ;
  • Yoon, Seong Guk (Department of Radiology, Dong-A University College of Medicine) ;
  • Sung, Gyung Tak (Department of Urology, Dong-A University College of Medicine)
  • 발행 : 2012.10.01
⟨ 이전 논문 다음 논문 ⟩

초록

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.

키워드

참고문헌

  1. Bosniak MA, Birnbaum BA, Krinsky GA, Waisman J. Small renal parenchymal neoplasms: further observations on growth. Radiology 1995;197:589-597 https://doi.org/10.1148/radiology.197.3.7480724
  2. 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;179:75-79; discussion 79-80
  3. Huang WC, Levey AS, Serio AM, Snyder M, Vickers AJ, Raj GV, et al. Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol 2006;7:735-740 https://doi.org/10.1016/S1470-2045(06)70803-8
  4. Campbell SC, Novick AC, Belldegrun A, Blute ML, Chow GK, Derweesh IH, et al. Guideline for management of the clinical T1 renal mass. J Urol 2009;182:1271-1279 https://doi.org/10.1016/j.juro.2009.07.004
  5. Herr HW. Partial nephrectomy for unilateral renal carcinoma and a normal contralateral kidney: 10-year followup. J Urol 1999;161:33-34; discussion 34-35 https://doi.org/10.1016/S0022-5347(01)62052-4
  6. Fergany AF, Hafez KS, Novick AC. Long-term results of nephron sparing surgery for localized renal cell carcinoma: 10-year followup. J Urol 2000;163:442-445 https://doi.org/10.1016/S0022-5347(05)67896-2
  7. Gill IS, Kavoussi LR, Lane BR, Blute ML, Babineau D, Colombo JR Jr, et al. Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol 2007;178:41-46 https://doi.org/10.1016/j.juro.2007.03.038
  8. Park H, Byun SS, Kim HH, Lee SB, Kwon TG, Jeon SH, et al. Comparison of laparoscopic and open partial nephrectomies in t1a renal cell carcinoma: a Korean multicenter experience. Korean J Urol 2010;51:467-471 https://doi.org/10.4111/kju.2010.51.7.467
  9. Pasticier G, Timsit MO, Badet L, De La Torre Abril L, Halila M, Fassi Fehri H, et al. Nephron-sparing surgery for renal cell carcinoma: detailed analysis of complications over a 15-year period. Eur Urol 2006;49:485-490 https://doi.org/10.1016/j.eururo.2005.12.049
  10. Zlotta AR, Wildschutz T, Raviv G, Peny MO, van Gansbeke D, Noel JC, et al. Radiofrequency interstitial tumor ablation (RITA) is a possible new modality for treatment of renal cancer: ex vivo and in vivo experience. J Endourol 1997;11:251-258 https://doi.org/10.1089/end.1997.11.251
  11. Gervais DA, McGovern FJ, Arellano RS, McDougal WS, Mueller PR. Radiofrequency ablation of renal cell carcinoma: part 1, Indications, results, and role in patient management over a 6-year period and ablation of 100 tumors. AJR Am J Roentgenol 2005;185:64-71 https://doi.org/10.2214/ajr.185.1.01850064
  12. Matsumoto ED, Johnson DB, Ogan K, Trimmer C, Sagalowsky A, Margulis V, et al. Short-term efficacy of temperaturebased radiofrequency ablation of small renal tumors. Urology 2005;65:877-881 https://doi.org/10.1016/j.urology.2004.12.011
  13. Park SH, Yoon SK, Cho JH, Oh JY, Nam KJ, Kwon HJ, et al. Radiofrequency ablation treatment for renal cell carcinoma: early clinical experience. Korean J Radiol 2008;9:340-347 https://doi.org/10.3348/kjr.2008.9.4.340
  14. Farrell MA, Charboneau WJ, DiMarco DS, Chow GK, Zincke H, Callstrom MR, et al. Imaging-guided radiofrequency ablation of solid renal tumors. AJR Am J Roentgenol 2003;180:1509- 1513 https://doi.org/10.2214/ajr.180.6.1801509
  15. Park S, Anderson JK, Matsumoto ED, Lotan Y, Josephs S, Cadeddu JA. Radiofrequency ablation of renal tumors: intermediate-term results. J Endourol 2006;20:569-573 https://doi.org/10.1089/end.2006.20.569
  16. Kim JH, Kim TH, Kim SD, Lee KS, Sung GT. Radiofrequency ablation of renal tumors: our experience. Korean J Urol 2011;52:531-537 https://doi.org/10.4111/kju.2011.52.8.531
  17. Wingo MS, Leveillee RJ. Central and deep renal tumors can be effectively ablated: radiofrequency ablation outcomes with fiberoptic peripheral temperature monitoring. J Endourol 2008;22:1261-1267 https://doi.org/10.1089/end.2008.0135
  18. Mylona S, Kokkinaki A, Pomoni M, Galani P, Ntai S, Thanos L. Percutaneous radiofrequency ablation of renal cell carcinomas in patients with solitary kidney: 6 years experience. Eur J Radiol 2009;69:351-356 https://doi.org/10.1016/j.ejrad.2007.10.004
  19. Watkins TW, Parkinson R. Percutaneous radiofrequency ablation of renal tumours: case series of 11 tumours and review of published work. Australas Radiol 2007;51:412-419 https://doi.org/10.1111/j.1440-1673.2007.01862.x
  20. Salas N, Ramanathan R, Dummett S, Leveillee RJ. Results of radiofrequency kidney tumor ablation: renal function preservation and oncologic efficacy. World J Urol 2010;28:583- 591 https://doi.org/10.1007/s00345-010-0562-2
  21. Breen DJ, Rutherford EE, Stedman B, Roy-Choudhury SH, Cast JE, Hayes MC, et al. Management of renal tumors by imageguided radiofrequency ablation: experience in 105 tumors. Cardiovasc Intervent Radiol 2007;30:936-942 https://doi.org/10.1007/s00270-007-9090-x
  22. Arima K, Yamakado K, Kinbara H, Nakatsuka A, Takeda K, Sugimura Y. Percutaneous radiofrequency ablation with transarterial embolization is useful for treatment of stage 1 renal cell carcinoma with surgical risk: results at 2-year mean follow up. Int J Urol 2007;14:585-590; discussion 590 https://doi.org/10.1111/j.1442-2042.2007.01740.x
  23. Zagoria RJ, Traver MA, Werle DM, Perini M, Hayasaka S, Clark PE. Oncologic efficacy of CT-guided percutaneous radiofrequency ablation of renal cell carcinomas. AJR Am J Roentgenol 2007;189:429-436 https://doi.org/10.2214/AJR.07.2258
  24. Weight CJ, Kaouk JH, Hegarty NJ, Remer EM, O'Malley CM, Lane BR, et al. Correlation of radiographic imaging and histopathology following cryoablation and radio frequency ablation for renal tumors. J Urol 2008;179:1277-1281; discussion 1281-1283 https://doi.org/10.1016/j.juro.2007.11.075
  25. Tracy CR, Raman JD, Donnally C, Trimmer CK, Cadeddu JA. Durable oncologic outcomes after radiofrequency ablation: experience from treating 243 small renal masses over 7.5 years. Cancer 2010;116:3135-3142 https://doi.org/10.1002/cncr.25002
  26. Raman JD, Stern JM, Zeltser I, Kabbani W, Cadeddu JA. Absence of viable renal carcinoma in biopsies performed more than 1 year following radio frequency ablation confirms reliability of axial imaging. J Urol 2008;179:2142-2145 https://doi.org/10.1016/j.juro.2008.01.119
  27. Aron M, Gill IS. Renal tumor ablation. Curr Opin Urol 2005;15:298-305 https://doi.org/10.1097/01.mou.0000177684.93531.85
  28. Kwan KG, Matsumoto ED. Radiofrequency ablation and cryoablation of renal tumours. Curr Oncol 2007;14:34-38 https://doi.org/10.3747/co.2007.113
  29. Arzola J, Baughman SM, Hernandez J, Bishoff JT. Computed tomography-guided, resistance-based, percutaneous radiofrequency ablation of renal malignancies under conscious sedation at two years of follow-up. Urology 2006;68:983-987 https://doi.org/10.1016/j.urology.2006.06.014
  30. Levinson AW, Su LM, Agarwal D, Sroka M, Jarrett TW, Kavoussi LR, et al. Long-term oncological and overall outcomes of percutaneous radio frequency ablation in high risk surgical patients with a solitary small renal mass. J Urol 2008;180:499-504; discussion 504 https://doi.org/10.1016/j.juro.2008.04.031
  31. Ahrar K, Matin S, Wood CG, Wallace MJ, Gupta S, Madoff DC, et al. Percutaneous radiofrequency ablation of renal tumors: technique, complications, and outcomes. J Vasc Interv Radiol 2005;16:679-688 https://doi.org/10.1097/01.RVI.0000153589.10908.5F
  32. Mahnken AH, Rohde D, Brkovic D, Gunther RW, Tacke JA. Percutaneous radiofrequency ablation of renal cell carcinoma: preliminary results. Acta Radiol 2005;46:208-214 https://doi.org/10.1080/02841850510015938
  33. Kummerlin IP, Borrego J, Wink MH, Van Dijk MM, Wijkstra H, de la Rosette JJ, et al. Nephron-sparing surgery and percutaneous biopsies in renal-cell carcinoma: a global impression among endourologists. J Endourol 2007;21:709- 713 https://doi.org/10.1089/end.2006.0409

피인용 문헌

  1. 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 vol.14, pp.11, 2012, https://doi.org/10.7314/apjcp.2013.14.11.6637
  2. Comparative Outcome of Computed Tomography-guided Percutaneous Radiofrequency Ablation, Partial Nephrectomy or Radical Nephrectomy in the Treatment of Stage T1 Renal Cell Carcinoma vol.7, pp.1, 2012, https://doi.org/10.4081/rt.2015.5583
  3. Safety and feasibility of radiofrequency ablation for treatment of Bosniak IV renal cysts vol.42, pp.3, 2016, https://doi.org/10.1590/s1677-5538.ibju.2015.0444
  4. Complications of ultrasound-guided percutaneous microwave ablation of renal cell carcinoma vol.9, pp.None, 2012, https://doi.org/10.2147/ott.s109783
  5. Guía de manejo del carcinoma de células renales vol.25, pp.2, 2016, https://doi.org/10.1016/j.uroco.2016.03.002
  6. CIRSE Guidelines on Percutaneous Ablation of Small Renal Cell Carcinoma vol.40, pp.2, 2012, https://doi.org/10.1007/s00270-016-1531-y
  7. Renal Cell Carcinoma: Alternative Nephron-Sparing Treatment Options for Small Renal Masses, a Systematic Review vol.31, pp.10, 2017, https://doi.org/10.1089/end.2017.0382
  8. Endovascular Embolization of Renal Cell Carcinoma in a Patient with Solitary Kidney vol.82, pp.None, 2012, https://doi.org/10.12659/pjr.901219
  9. Comparison of Chronologic Change in the Size and Contrast-Enhancement of Ablation Zones on CT Images after Irreversible Electroporation and Radiofrequency Ablation vol.19, pp.4, 2012, https://doi.org/10.3348/kjr.2018.19.4.560