Percutaneous radio frequency ablation of renal masses: results at a 2-year mean followup.
OBJECTIVE
We describe our experience with and results of percutaneous computerized tomography guided radio frequency ablation (RFA) for small (less than 4 cm) renal tumors at a 2-year mean followup.


METHODS
A total of 49 patients (60 renal tumors) with a mean age of 63.9 years underwent percutaneous RFA. Indications for RFA were severe comorbidities or previous abdominal surgery precluding operative management, or hereditary conditions predisposing to multiple tumor recurrence. Persistent enhancement on initial followup imaging was considered incomplete treatment and all such patients underwent biopsy and were offered repeat RFA. Enhancement or enlargement on subsequent imaging was considered tumor recurrence and these patients were counseled regarding further therapy.


RESULTS
Three patients (4 tumors) were excluded from evaluation due to death from unrelated causes or loss to followup. A total of 46 patients (56 tumors) were available for evaluation at a mean followup of 27.5 months (range 12 to 48). Six tumors were incompletely treated with the first RFA and successfully treated with a second session. Recurrences after successful initial treatment were seen in 3 of 46 patients. These recurrences developed 24, 25 and 31 months following RFA, respectively, and all occurred in patients with a central tumor of 3.0 cm or greater. Overall local control was achieved in 94.6% of tumors (53 of 56).


CONCLUSIONS
RFA is an emerging alternative treatment modality for small renal tumors. Larger (greater than 3.0 cm) central tumors represent unique technical challenges, making these tumors more prone to recurrence. Long-term followup is needed to establish the oncological durability of this technique.
Varkarakis
Ioannis M
IM
The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
Allaf
Mohamad E
ME
Inagaki
Takeshi
T
Bhayani
Sam B
SB
Chan
David Y
DY
Su
Li-Ming
LM
Jarrett
Thomas W
TW
Kavoussi
Louis R
LR
Solomon
Stephen B
SB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome