Minimally invasive ablative approaches in the treatment of renal cell carcinoma.
Ablative techniques for the treatment of renal cell carcinoma (RCC) are an extension of nephron-sparing surgery and include cryoablation, radiofrequency ablation (RFA), and high-intensity focused ultrasound (HIFU). Although experimental, these are evolving treatment modalities. The widespread use of computed tomography scans, ultrasound, and magnetic resonance imaging caused an increase in the diagnosis rate of small renal masses amenable to nephron-sparing surgery. The same imaging modalities permit interactive monitoring both during the delivery of ablative measures and at postoperative follow-up. Cryosurgery is the most studied of the ablative approaches, and clinical studies have demonstrated promising short-term results and a remarkable safety profile. Long-term studies, however, are needed in order to determine the appropriate selection criteria and to confirm a response as durable as that for partial and radical nephrectomy. More data are needed to evaluate the efficacy of RFA. Currently, preclinical results with HIFU do not justify its use for treating RCC in humans.
Janzen
Nicolette
N
UCLA Department of Urology, 10833 Le Conte Ave., CHS 66-118, Los Angeles, CA 90035, USA.
Zisman
Amnon
A
Pantuck
Allan J
AJ
Perry
Kent
K
Schulam
Peter
P
Belldegrun
Arie S
AS
D002292:Carcinoma, Renal Cell / Q000601:surgery*; D003452:Cryosurgery; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures; D014464:Ultrasonic Therapy; D013520:Urologic Surgical Procedures / Q000379:methods