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Radiofrequency ablation treatment for renal cell carcinoma: early clinical experience.

Park SH, Yoon SK, Cho JH, Oh JY, Nam KJ, Kwon HJ, Kim SY, Kang MJ, Choi S, Sung GT - Korean J Radiol (2008 Jul-Aug)

Bottom Line: The treatment indications were localized, solid renal mass, comorbidities, high operation risk, and refusal to perform surgery.Technical success and effectiveness was achieved in all cases and the mean follow-up period was 23.8 months (range, 17-33 months).A local recurrence was not detected in any of the cases; however, five patients developed complications as a result of treatment, including hematuria (n = 2), mild thermal injury of the psoas muscle (n = 1), mild hydronephrosis (n = 1), and fistula formation (n = 1).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Dong-A University College of Medicine, Busan, Korea.

ABSTRACT

Objective: To evaluate the early clinical experience associated with radiofrequency (RF) ablation in patients with renal cell carcinoma (RCC).

Materials and methods: The RF ablation treatment was performed on 17 tumors from 16 patients (mean age, 60.5 years; range, 43-73 years) with RCC. The treatment indications were localized, solid renal mass, comorbidities, high operation risk, and refusal to perform surgery. All tumors were treated by a percutaneous CT (n = 10), followed by an US-guided (n = 2), laparoscopy-assisted US (n = 2), and an open (n = 2) RF ablation. Furthermore, patients underwent a follow-up CT at one day, one week, one month, three and six months, and then every six months from the onset of treatment. We evaluated the technical success, technical effectiveness, ablation zone, benign periablation enhancement, irregular peripheral enhancement, and complications.

Results: All 17 exophytic tumors (mean size, 2.2 cm; range, 1.1-5.0 cm) were completely ablated. Technical success and effectiveness was achieved in all cases and the mean follow-up period was 23.8 months (range, 17-33 months). A local recurrence was not detected in any of the cases; however, five patients developed complications as a result of treatment, including hematuria (n = 2), mild thermal injury of the psoas muscle (n = 1), mild hydronephrosis (n = 1), and fistula formation (n = 1).

Conclusion: The RF ablation is an alternative treatment for exophytic RCCs and represents a promising treatment for some patients with small RCCs.

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Well ablated, small exophytic renal cell carainoma in 56-year-old woman who underwent RF ablation.A. Contrast-enhanced CT scan before RF ablation demonstrates solid enhancing exophytic renal tumor located at lower polar region of left kidney (arrow).B. RF ablation of tumor was performed under CT guidance. Unenhanced CT scan during treatment demonstrates electrode within renal tumor (arrow).C. One-month follow-up contrast-enhanced CT scan demonstrates no periablation enhancement or residual contrast enhancement within tumor bed (arrow), indicating technical success.D. Two-year follow-up contrast-enhanced CT scan demonstrates no areas of abnormal contrast enhancement within tumor and shows further decrease in size of renal tumor (arrow).
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Figure 1: Well ablated, small exophytic renal cell carainoma in 56-year-old woman who underwent RF ablation.A. Contrast-enhanced CT scan before RF ablation demonstrates solid enhancing exophytic renal tumor located at lower polar region of left kidney (arrow).B. RF ablation of tumor was performed under CT guidance. Unenhanced CT scan during treatment demonstrates electrode within renal tumor (arrow).C. One-month follow-up contrast-enhanced CT scan demonstrates no periablation enhancement or residual contrast enhancement within tumor bed (arrow), indicating technical success.D. Two-year follow-up contrast-enhanced CT scan demonstrates no areas of abnormal contrast enhancement within tumor and shows further decrease in size of renal tumor (arrow).

Mentions: The treatment data for each patient are summarized in Table 2. All the 17 renal tumors observed in the 16 patients were subjected to an RF ablation treatment. The mean tumor size was 2.2 cm (range, 1.6-5.0 cm), and all tumors were exophytic. The mean CT follow-up period was 23.8 months (range, 17-33 months). Over the radiologic follow-up period, a total of 13 tumors in 12 patients were successfully treated in one ablation session (Fig. 1), and four tumors from four patients required more than one session based upon follow-up CT scan results. One tumor required 3 sessions, as a result of persistent enhancement within the tumor. Also, seven tumors from seven patients required electrode repositions since the tumor size was too large. Technical success and technical effectiveness rates were achieved in all cases (100%) and the mean total procedure time was 97.8 minutes (range, 32-260 minutes). However, except for the open approach, the mean procedure time was 83.6 minutes.


Radiofrequency ablation treatment for renal cell carcinoma: early clinical experience.

Park SH, Yoon SK, Cho JH, Oh JY, Nam KJ, Kwon HJ, Kim SY, Kang MJ, Choi S, Sung GT - Korean J Radiol (2008 Jul-Aug)

Well ablated, small exophytic renal cell carainoma in 56-year-old woman who underwent RF ablation.A. Contrast-enhanced CT scan before RF ablation demonstrates solid enhancing exophytic renal tumor located at lower polar region of left kidney (arrow).B. RF ablation of tumor was performed under CT guidance. Unenhanced CT scan during treatment demonstrates electrode within renal tumor (arrow).C. One-month follow-up contrast-enhanced CT scan demonstrates no periablation enhancement or residual contrast enhancement within tumor bed (arrow), indicating technical success.D. Two-year follow-up contrast-enhanced CT scan demonstrates no areas of abnormal contrast enhancement within tumor and shows further decrease in size of renal tumor (arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627268&req=5

Figure 1: Well ablated, small exophytic renal cell carainoma in 56-year-old woman who underwent RF ablation.A. Contrast-enhanced CT scan before RF ablation demonstrates solid enhancing exophytic renal tumor located at lower polar region of left kidney (arrow).B. RF ablation of tumor was performed under CT guidance. Unenhanced CT scan during treatment demonstrates electrode within renal tumor (arrow).C. One-month follow-up contrast-enhanced CT scan demonstrates no periablation enhancement or residual contrast enhancement within tumor bed (arrow), indicating technical success.D. Two-year follow-up contrast-enhanced CT scan demonstrates no areas of abnormal contrast enhancement within tumor and shows further decrease in size of renal tumor (arrow).
Mentions: The treatment data for each patient are summarized in Table 2. All the 17 renal tumors observed in the 16 patients were subjected to an RF ablation treatment. The mean tumor size was 2.2 cm (range, 1.6-5.0 cm), and all tumors were exophytic. The mean CT follow-up period was 23.8 months (range, 17-33 months). Over the radiologic follow-up period, a total of 13 tumors in 12 patients were successfully treated in one ablation session (Fig. 1), and four tumors from four patients required more than one session based upon follow-up CT scan results. One tumor required 3 sessions, as a result of persistent enhancement within the tumor. Also, seven tumors from seven patients required electrode repositions since the tumor size was too large. Technical success and technical effectiveness rates were achieved in all cases (100%) and the mean total procedure time was 97.8 minutes (range, 32-260 minutes). However, except for the open approach, the mean procedure time was 83.6 minutes.

Bottom Line: The treatment indications were localized, solid renal mass, comorbidities, high operation risk, and refusal to perform surgery.Technical success and effectiveness was achieved in all cases and the mean follow-up period was 23.8 months (range, 17-33 months).A local recurrence was not detected in any of the cases; however, five patients developed complications as a result of treatment, including hematuria (n = 2), mild thermal injury of the psoas muscle (n = 1), mild hydronephrosis (n = 1), and fistula formation (n = 1).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Dong-A University College of Medicine, Busan, Korea.

ABSTRACT

Objective: To evaluate the early clinical experience associated with radiofrequency (RF) ablation in patients with renal cell carcinoma (RCC).

Materials and methods: The RF ablation treatment was performed on 17 tumors from 16 patients (mean age, 60.5 years; range, 43-73 years) with RCC. The treatment indications were localized, solid renal mass, comorbidities, high operation risk, and refusal to perform surgery. All tumors were treated by a percutaneous CT (n = 10), followed by an US-guided (n = 2), laparoscopy-assisted US (n = 2), and an open (n = 2) RF ablation. Furthermore, patients underwent a follow-up CT at one day, one week, one month, three and six months, and then every six months from the onset of treatment. We evaluated the technical success, technical effectiveness, ablation zone, benign periablation enhancement, irregular peripheral enhancement, and complications.

Results: All 17 exophytic tumors (mean size, 2.2 cm; range, 1.1-5.0 cm) were completely ablated. Technical success and effectiveness was achieved in all cases and the mean follow-up period was 23.8 months (range, 17-33 months). A local recurrence was not detected in any of the cases; however, five patients developed complications as a result of treatment, including hematuria (n = 2), mild thermal injury of the psoas muscle (n = 1), mild hydronephrosis (n = 1), and fistula formation (n = 1).

Conclusion: The RF ablation is an alternative treatment for exophytic RCCs and represents a promising treatment for some patients with small RCCs.

Show MeSH
Related in: MedlinePlus