Radiofrequency ablation combined with renal arterial embolization for the treatment of unresectable renal cell carcinoma larger than 3.5 cm: initial experience.
The purpose of the study was to evaluate the feasibility, safety, and therapeutic effects of the combination of renal arterial embolization and radiofrequency (RF) ablation to reinforce the anticancer effect on renal cell carcinomas (RCCs) measuring 3.5 cm or larger. This study was undertaken to evaluate this combined therapy on large RCCs-based tumor geometry. Eleven patients with 12 RCCs 3.5 cm or larger in diameter (3.5-9.0 cm) underwent combined therapy. Two were exophytic tumors, and the remaining 10 tumors had components extending into the renal sinus fat. Tumor vessels were selectively embolized in nine patients and the renal artery was completely embolized in two patients with polyvinyl alcohol or ethanol mixed with iodized oil. RF ablation was percutaneously done under the computed tomographic (CT)-fluoroscopic guidance. Response to treatment was evaluated by dynamic contrast-enhanced CT and magnetic resonance (MR) imaging. Tumor enhancement was eliminated after a single RF session in nine tumors (75%), after two sessions in two tumors (17%), and after four sessions in one tumor (8%). Both exophytic tumors (100%) and 7 of 10 tumors having components in the renal sinus fat (70%) were completely ablated with a single RF session. All tumors remained controlled during a mean follow-up period of 13 months and showed significant reduction in tumor sizes (5.2 +/- 1.7 cm to 3.6 +/- 1.4 cm, p < 0.001). A delayed abscess developed in the ablated lesion in a patient, which was percutaneously drainaged. Combined therapy as described in this report is a feasible, relatively safe, and promising treatment method for large RCCs regardless of tumor geometry.
Yamakado
Koichiro
K
Department of Radiology, Mie University School of Medicine, Tsu, Mie, Japan. yama@clin.medic.mie-u.ac.jp
Nakatsuka
Atsuhiro
A
Kobayashi
Shigeki
S
Akeboshi
Masao
M
Takaki
Haruyuki
H
Kariya
Zentaro
Z
Kinbara
Hiroyuki
H
Arima
Kiminobu
K
Yanagawa
Makoto
M
Hori
Yasuhide
Y
Kato
Hiromi
H
Sugimura
Yoshiki
Y
Takeda
Kan
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000628:therapy*; D017115:Catheter Ablation; D003131:Combined Modality Therapy; D003287:Contrast Media; D004621:Embolization, Therapeutic; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015641:Radiography, Interventional; D012077:Renal Artery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D003287:Contrast Media