title: Radiofrequency ablation combined with renal arterial embolization for the treatment of unresectable renal cell carcinoma larger than 3.5 cm: initial experience.
abstract: 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.
authors.affiliation: Department of Radiology, Mie University School of Medicine, Tsu, Mie, Japan. yama@clin.medic.mie-u.ac.jp
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yamakado
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Nakatsuka
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Masao
authors.initials: M
authors.lastname: Akeboshi
authors.forename: Haruyuki
authors.initials: H
authors.lastname: Takaki
authors.forename: Zentaro
authors.initials: Z
authors.lastname: Kariya
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kinbara
authors.forename: Kiminobu
authors.initials: K
authors.lastname: Arima
authors.forename: Makoto
authors.initials: M
authors.lastname: Yanagawa
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Hori
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kato
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sugimura
authors.forename: Kan
authors.initials: K
authors.lastname: Takeda
mesh_terms: 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
chemical_list: D003287:Contrast Media