Management of renal tumors by image-guided radiofrequency ablation: experience in 105 tumors

• Published in: Cardiovascular and interventional radiology 2007-09, Vol.30 (5), p.936-942
• Main Authors: Breen, David J, Rutherford, Elizabeth E, Stedman, Brian, Roy-Choudhury, Shuvro H, Cast, James E I, Hayes, Matthew C, Smart, Christopher J
• Format: Article
• Language: English
• Subjects: ABLATION; Adult; Aged; Aged, 80 and over; BIOMEDICAL RADIOGRAPHY; Catheter Ablation - adverse effects; Clinical Investigation; Female; Follow-Up Studies; Humans; Kidney Neoplasms - diagnostic imaging; Kidney Neoplasms - surgery; KIDNEYS; Male; Middle Aged; MULTIVARIATE ANALYSIS; NEOPLASMS; Radiography, Interventional - adverse effects; Radiography, Interventional - methods; RADIOLOGY AND NUCLEAR MEDICINE; RADIOWAVE RADIATION; Reoperation; Time Factors; Tomography, X-Ray Computed - adverse effects; Treatment Outcome; Tumors; Ultrasonography, Interventional - adverse effects
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-007-9090-x

In this article we present our experience with radiofrequency ablation (RFA) in the treatment of 105 renal tumors. RFA was performed on 105 renal tumors in 97 patients, with a mean tumor size of 32 mm (11-68 mm). The mean patient age was 71.7 years (range, 36-89 years). The ablations were carried out under ultrasound (n = 43) or CT (n = 62) guidance. Imaging follow-up was by contrast-enhanced CT within 10 days and then at 6-monthly intervals. Multivariate analysis was performed to determine variables associated with procedural outcome. Eighty-three tumors were completely treated at a single sitting (79%). Twelve of the remaining tumors were successfully re-treated and a clinical decision was made not to re-treat seven patients. A patient with a small residual crescent of tumor is under follow-up and may require further treatment. In another patient, re-treatment was abandoned due to complicating pneumothorax and difficult access. One patient is awaiting further re-treatment. The overall technical success rate was 90.5%. Multivariate analysis revealed tumor size to be the only significant variable affecting procedural outcome. (p = 0.007, Pearson chi(2)) Five patients had complications. There have been no local recurrences. Our experience to date suggests that RFA is a safe and effective, minimally invasive treatment for small renal tumors.