Incomplete renal tumor destruction using radio frequency interstitial ablation.
OBJECTIVE
We evaluate the efficacy of temperature based radio frequency ablation as a potential treatment modality for small (less than 3.5 cm.) renal tumors.


METHODS
We treated 15 patients with a total of 20 tumors with radio frequency ablation through an open surgical approach immediately before partial nephrectomy. All tumors were biopsied before radio frequency ablation treatment. Tumors were heated to 90 to 110C for 6 to 16 minutes (mean 9.1). Tumor ablation was monitored by direct vision and ultrasound. Partial nephrectomy was performed in standard fashion. All specimens were stained with hematoxylin and eosin, and 5 specimens were stained for nicotinamide adenine dinucleotide (NADH) diaphorase activity.


RESULTS
Tumors ranged from 1.5 to 3.5 cm. (mean 2.4) in greatest dimension. All 20 specimens had evidence of morphologically unchanged tumor and normal renal parenchyma on standard hematoxylin and eosin staining. Of the 5 specimens 4 stained positively for NADH in areas confirmed to be tumor in hematoxylin and eosin stained neighboring sections. There was 1 intraoperative renal pelvic thermal injury requiring pyeloplasty and 2 postoperative caliceal leaks requiring stent placement.


CONCLUSIONS
In our series radio frequency therapy did not result in total tumor destruction when specimens were examined with hematoxylin and eosin or NADH staining. We believe that radio frequency interstitial tumor ablation of renal cell carcinoma without subsequent tissue resection should continue to be an investigational treatment modality for those who would otherwise undergo partial or radical nephrectomy.
Michaels
Mike J
MJ
Department of Urology, Lahey Clinic and Cell and Molecular Biology Laboratory, Robert E. Wise Research and Education Institute, Burlington, Massachusetts, USA.
Rhee
Harrison K
HK
Mourtzinos
Arthur P
AP
Summerhayes
Ian C
IC
Silverman
Mark L
ML
Libertino
John A
JA
D001706:Biopsy; D002292:Carcinoma, Renal Cell / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D017115:Catheter Ablation / Q000009:adverse effects; D008058:Dihydrolipoamide Dehydrogenase / Q000032:analysis; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D008297:Male; D009392:Nephrectomy; D017211:Treatment Failure
D008058:Dihydrolipoamide Dehydrogenase