title: Residual and recurrent disease following renal energy ablative therapy: a multi-institutional study.
abstract: 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.
authors.affiliation: Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA. surmatin@mdanderson.org
authors.forename: Surena F
authors.initials: SF
authors.lastname: Matin
authors.forename: Kamran
authors.initials: K
authors.lastname: Ahrar
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Cadeddu
authors.forename: Debra A
authors.initials: DA
authors.lastname: Gervais
authors.forename: Francis J
authors.initials: FJ
authors.lastname: McGovern
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Zagoria
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Zagoria
authors.forename: Robert G
authors.initials: RG
authors.lastname: Uzzo
authors.forename: John
authors.initials: J
authors.lastname: Haaga
authors.forename: Martin I
authors.initials: MI
authors.lastname: Resnick
authors.forename: Jihad
authors.initials: J
authors.lastname: Kaouk
authors.forename: Inderbir S
authors.initials: IS
authors.lastname: Gill
mesh_terms: 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