Residual and recurrent disease following renal energy ablative therapy: a multi-institutional study.
OBJECTIVE
In this study we detail the incidence and pattern of residual and recurrent disease after radio frequency ablation or cryoablation of a renal mass and, using this information, determine reasonable minimum recommendations for when to perform surveillance imaging during year 1 after treatment. To our knowledge no evidence based guidelines exist for determining how or when followup abdominal imaging should be performed after renal energy ablative therapy.


METHODS
We reviewed treatment and followup information of patients who underwent radio frequency ablation or cryoablation for a renal mass at 7 institutions. Postoperative monitoring was performed using a variety of surveillance schedules.


RESULTS
Of 616 patients 63 were found to have residual or recurrent disease after primary radio frequency ablation (13.4%) or cryoablation (3.9%) for a median of 8.7% in 7 institutions. Most incomplete treatments (70%) were detected within the first 3 months. After salvage ablative therapy was rendered, therapy failed in only 4.2%. At a mean followup of 2 years patients with residual or recurrent disease had an overall survival rate of 82.5% and a 2-year metastasis-free survival rate of 97.4% for those with localized, unilateral renal tumors.


CONCLUSIONS
In most cases initial treatment failure was detected within the first 3 months after treatment. Our findings support a minimum of 3 to 4 imaging studies in year 1 after ablative therapy, and at months 1, 3, 6 (optional) and 12.
Matin
Surena F
SF
Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA. surmatin@mdanderson.org
Ahrar
Kamran
K
Cadeddu
Jeffrey A
JA
Gervais
Debra A
DA
McGovern
Francis J
FJ
Zagoria
Ronald J
RJ
Zagoria
Ronald A
RA
Uzzo
Robert G
RG
Haaga
John
J
Resnick
Martin I
MI
Kaouk
Jihad
J
Gill
Inderbir S
IS
D017115:Catheter Ablation; D003452:Cryosurgery; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007680:Kidney Neoplasms / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D018365:Neoplasm, Residual