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.
OBJECTIVE
The objectives of our article are to review our experience with radiofrequency ablation of renal cell carcinoma and to assess size and location as predictors of the ability to achieve complete necrosis by imaging criteria.


METHODS
Over a 6-year period, 100 renal tumors in 85 patients underwent radiofrequency ablation at a single institution. The absence of enhancement on CT or MRI after radiofrequency ablation was interpreted as complete coagulation necrosis. Results were analyzed by tumor size and location using multivariate analysis. A p value of 0.05 or less was considered significant.


RESULTS
All 52 small (3 cm) and all 68 exophytic tumors underwent complete necrosis regardless of size, although many large tumors (> 3 cm) required a second ablation session. Using multivariate analysis, we found that both small size (p < 0.0001) and noncentral location (p = 0.0049) proved to be independent predictors of complete necrosis after a single ablation session. Location was a significant predictor (p = 0.015) of complete necrosis after any number of sessions, whereas size showed a strong trend (p = 0.059) toward predicting success after any number of sessions. Complications were either self-limited or readily treated and included hemorrhage (major, n = 2; minor, n = 3), inflammatory track mass (n = 1), transient lumbar plexus pain (n = 2), ureteral injury (n = 2), and skin burns (n = 1).


CONCLUSIONS
Radiofrequency ablation is a promising minimally invasive therapy for renal cell carcinoma in patients who are not good operative candidates. Small size and noncentral location are favorable tumor characteristics, although large tumors can sometimes be successfully treated with multiple ablation sessions.
Department of Radiology, Massachusetts General Hospital, 55 Fruit St., White 270, Boston, MA 02114, USA.
Debra A
DA
Gervais
Francis J
FJ
McGovern
Ronald S
RS
Arellano
W Scott
WS
McDougal
Peter R
PR
Mueller
D000368:Aged; D002292:Carcinoma, Renal Cell / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000473:pathology; D007680:Kidney Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D015999:Multivariate Analysis; D009336:Necrosis; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D014057:Tomography, X-Ray Computed