Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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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

  • Yuksel, Mehmet Bilgehan (Department of Urology, Faculty of Medicine, Celal Bayar University) ;
  • Karakose, Ayhan (Department of Urology, School of Medicine, Izmir University) ;
  • Gumus, Bilal (Department of Urology, Faculty of Medicine, Celal Bayar University) ;
  • Tarhan, Serdar (Department of Radiology, Faculty of Medicine, Celal Bayar University) ;
  • Atesci, Yusuf Ziya (Department of Urology, School of Medicine, Izmir University) ;
  • Akan, Zafer (Department of Biophysics, Faculty of Medicine, Celal Bayar University)
  • Published : 2013.11.30
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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 $65.3{\pm}8.5$ (52-76) years. The mean tumor size was $29.6{\pm}6.08$ (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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References

  1. Altunrende F, Autorino R, Hillyer S, et al (2011). Image guided percutaneous probe ablation for renal tumors in 65 solitary kidneys, functional and oncological outcomes. J Urol, 186, 35-41. https://doi.org/10.1016/j.juro.2011.03.024
  2. Arima K, Yamakado K, Kinbara H, et al (2007). 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, 14, 585-90. https://doi.org/10.1111/j.1442-2042.2007.01740.x
  3. Aron M, Gill IS (2005). Renal tumor ablation. Curr Opin Urol, 15, 298-305. https://doi.org/10.1097/01.mou.0000177684.93531.85
  4. Atwell TD, Carter RE, Schmit GD, et al (2012). Complications following 573 percutaneous renal RF and cryoablation procedures. J Vasc Interv Radiol, 23, 48-54. https://doi.org/10.1016/j.jvir.2011.09.008
  5. Best SL, Park SK, Yaacoub RF, et al (2012). Long term outcomes of renal tumors RFA stratified by tumor diameter, size matters. J Urol, 187, 1183-9. https://doi.org/10.1016/j.juro.2011.11.096
  6. Breau RH, Crispen PL, Jenkins SM, et al (2011). Treatment of patients with small renal masses, a survey of the American urological association. J Urol, 185, 407-13. https://doi.org/10.1016/j.juro.2010.09.092
  7. Breen DJ, Rutherford EE, Stedman B, et al (2007). Management of renal tumors by image- guided radiofrequency ablation, experience in 105 tumors. Cardiovasc Intervent Radiol, 30, 936-42. https://doi.org/10.1007/s00270-007-9090-x
  8. Campbell SC, Novick AC, Bukowski RM (2007). Renal tumors. In, Campbell MF, Wein AJ, Kavoussi LR, eds. Campbell-Walsh Urology. 9th ed. Philadelphia, PA, Saunders Elsevier, 1567-637.
  9. Campbell SC, Novick AC, Belldegrun A, et al (2009). Guideline for management of the clinical T1 renal mass. J Urol, 182, 1271-9. https://doi.org/10.1016/j.juro.2009.07.004
  10. Chen DY, Uzzo RG (2009). Optimal management of localized renal cell carcinoma, surgery, ablation, or active surveillance. J Natl Compr Canc Netw, 7, 635-42. https://doi.org/10.6004/jnccn.2009.0044
  11. Del Cura JL, Zabala R, Iriarte JI, et al (2010). Treatment of renal tumors by percutaneous ultrasound-guided radiofrequency ablation using a multitined electrode, effectiveness and complications. Eur Urol, 57, 459-65. https://doi.org/10.1016/j.eururo.2009.11.025
  12. Ferakis N, Bouropoulos C, Granitsas T, et al (2010). Long-term results after computed tomography-guided percutaneous radiofrequency ablation for small renal tumors. J Endourol, 24, 1909-13. https://doi.org/10.1089/end.2009.0639
  13. Fergany AF, Hafez KS, Novick AC (2000). Long-term results of nephron sparing surgery for localized renal cell carcinoma, 10-year followup. J Urol, 163, 442-5. https://doi.org/10.1016/S0022-5347(05)67896-2
  14. Gervais DA, McGovern FJ, Arellano RS, et al (2005). 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, 185, 64-71. https://doi.org/10.2214/ajr.185.1.01850064
  15. Gill IS, Kavoussi LR, Lane BR, et al (2007). Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol, 178, 41-6. https://doi.org/10.1016/j.juro.2007.03.038
  16. Hacker A, Vallo S, Weiss C, et al (2006). Technical characterization of a new bipolar and multipolar radiofrequency device for minimally invasive treatment of renal tumours. BJU Int, 97, 822-8. https://doi.org/10.1111/j.1464-410X.2006.06038.x
  17. Huang WC, Levey AS, Serio AM, et al (2006). Chronic kidney disease after nephrectomy in patients with renal cortical tumours, a retrospective cohort study. Lancet Oncol, 7, 735-40. https://doi.org/10.1016/S1470-2045(06)70803-8
  18. Iannuccilli JD, Dupuy DE, Mayo-Smith WW (2012). Solid renal masses, effectiveness and safety of image-guided percutaneous radiofrequency ablation. Abdom Imaging, 37, 647-58. https://doi.org/10.1007/s00261-011-9807-9
  19. Ji C, Li X, Zhang S, et al (2011). Laparoscopic radiofrequency ablation of renal tumors, 32 months mean follow-up results of 106 patients. Urology, 77, 798-802. https://doi.org/10.1016/j.urology.2010.10.014
  20. Karam JA, Ahrar K, Vikram R, et al (2013). Radiofrequency ablation of renal tumours with clinical, radiographical and pathological results. BJU Int, 111, 997-1005. https://doi.org/10.1111/j.1464-410X.2012.11608.x
  21. Kwan KG, Matsumoto ED (2007). Radiofrequency ablation and cryoablation of renal tumours. Curr Oncol,14, 34-8. https://doi.org/10.3747/co.2007.113
  22. Kim SD, Yoon SG, Sung GT (2012). Radiofrequency ablation of renal tumors, four-year follow-up results in 47 patients. Korean J Radiol, 13, 625-33. https://doi.org/10.3348/kjr.2012.13.5.625
  23. Karam JA, Ahrar K, Vikram R, et al (2013). Radiofrequency ablation of renal tumours with clinical, radiographical and pathological results. BJU Int, 111, 997-1005. https://doi.org/10.1111/j.1464-410X.2012.11608.x
  24. Laguna M, Zondervan PJ, de la Rosette J (2012). Focal therapy in the management of small renal masses. Curr Opin Urol, 22, 372-8. https://doi.org/10.1097/MOU.0b013e328355a9a7
  25. Lucas SM, Stern JM, Adibi M, et al (2008). Renal function outcomes in patients treated for renal masses smaller than 4 cm by ablative and extirpative techniques. J Urol, 179, 75-9.
  26. Ljungberg B, Cowan NC, Hanbury DC, et al (2010). EAU guidelines on renal cell carcinoma, the 2010 update. Eur Urol, 58, 398-406. https://doi.org/10.1016/j.eururo.2010.06.032
  27. Matsumoto ED, Johnson DB, Ogan K, et al (2005). Short-term efficacy of temperature-(2012). based radiofrequency ablation of small renal tumors. Urology, 65, 877-81. https://doi.org/10.1016/j.urology.2004.12.011
  28. Mylona S, Kokkinaki A, Pomoni M, et al (2009). Percutaneous radiofrequency ablation of renal cell carcinomas in patients with solitary kidney, 6 years experience. Eur J Radiol, 69, 351-6. https://doi.org/10.1016/j.ejrad.2007.10.004
  29. Okhunov Z, Roy O, Duty B, et al (2012). Clinical evaluation of a novel bipolar radiofrequency ablation system for renal masses. BJU Int, 110, 688-91. https://doi.org/10.1111/j.1464-410X.2012.10940.x
  30. Park S, Anderson JK, Matsumoto ED, et al (2006). Radiofrequency ablation of renal tumors, intermediate-term results. J Endourol, 20, 569-73. https://doi.org/10.1089/end.2006.20.569
  31. Park BK, Kim CK, (2009). Complications of image-guided radiofrequency ablation of renal cell carcinoma, causes, imaging features, and prevention methods. Eur Radiol, 19, 2180-90. https://doi.org/10.1007/s00330-009-1399-1
  32. Pasticier G, Timsit MO, Badet L, et al (2006). Nephron-sparing surgery for renal cell carcinoma, detailed analysis of complications over a 15-year period. Eur Urol, 49, 485-90. https://doi.org/10.1016/j.eururo.2005.12.049
  33. Salas N, Ramanathan R, Dummett S, et al (2010). Results of radiofrequency kidney tumor ablation, renal function preservation and oncologic efficacy. World J Urol, 28, 583-91. https://doi.org/10.1007/s00345-010-0562-2
  34. Wingo MS, Leveillee RJ (2008). Central and deep renal tumors can be effectively ablated, radiofrequency ablation outcomes with fiberoptic peripheral temperature monitoring. J Endourol, 22, 1261-7. https://doi.org/10.1089/end.2008.0135
  35. Tracy CR, Raman JD, Donnally C, et al (2010). Durable oncologic outcomes after radiofrequency ablation, experience from treating 243 small renal masses over 7,5 years. Cancer, 116, 3135-42. https://doi.org/10.1002/cncr.25002
  36. Zagoria RJ, Traver MA, Werle DM, et al (2007). Oncologic efficacy of CT-guided percutaneous radiofrequency ablation of renal cell carcinomas. AJR Am J Roentgenol, 189, 429-36. https://doi.org/10.2214/AJR.07.2258
  37. Zlotta AR, Wildschutz T, Raviv G, et al (1997). Radiofrequency interstitial tumor ablation (RITA) is a possible new modality for treatment of renal cancer, ex vivo and in vivo experience. J Endourol, 11, 251-8. https://doi.org/10.1089/end.1997.11.251