Combined percutaneous radiofrequency ablation and ethanol injection of renal tumours: midterm results.
OBJECTIVE
To evaluate the safety and efficacy of combined percutaneous, image-guided, radiofrequency (RF) ablation and ethanol injection of renal tumours, and to present our midterm results.


METHODS
Since February 2002, 27 consecutive patients (22 men, 5 women; age range: 39-84 yr; mean: 69) with 28 renal tumours (mean diameter: 2.87cm) were treated with combined percutaneous RF and ethanol ablation, and were prospectively evaluated. Twenty-five patients were considered nonsurgical candidates because of comorbid conditions (16 patients) or had previous nephrectomy (9 patients), and 2 had refused surgery. Thirty-three ablation sessions were performed, with computed tomography (26 sessions), ultrasound (6), or combined magnetic resonance imaging/fluoroscopic guidance in 1. Absolute ethanol (0.5-3ml; mean: 1.7) was injected into the tumour immediately before treatment with radiofrequency. Mean follow-up period was 18.6 mo (range: 3-56).


RESULTS
Twenty-seven of the 28 tumours were completely ablated with either one (21 tumours) or two treatment sessions (6 tumours). One patient with residual disease refused further treatment. Only three minor complications, including a subcapsular haematoma and two patients with loin pain, occurred; all three patients were treated conservatively. None of the complications was related to the ethanol injection. During the follow-up period, no evidence of local recurrence or metastatic disease was seen. Creatinine levels have not changed significantly in any of the patients following ablation.


CONCLUSIONS
Combined use of percutaneous RF and ethanol ablation is a safe and effective alternative treatment for selective patients with renal tumours.
Fotiadis
Nicos I
NI
Department of Interventional Radiology, Guy's and St Thomas' Hospital, London, UK. nicos.fotiadis@kcl.ac.uk
Sabharwal
Tarun
T
Morales
Jose P
JP
Hodgson
Dominic J
DJ
O'Brien
Tim S
TS
Adam
Andreas
A
D018249:Adenoma, Oxyphilic / Q000175:diagnosis / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018207:Angiomyolipoma / Q000175:diagnosis / Q000628:therapy; D000891:Anti-Infective Agents, Local; D001706:Biopsy; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000628:therapy; D017115:Catheter Ablation / Q000379:methods*; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000891:Anti-Infective Agents, Local; D000431:Ethanol