Management of renal tumors by image-guided radiofrequency ablation: experience in 105 tumors.
OBJECTIVE
In this article we present our experience with radiofrequency ablation (RFA) in the treatment of 105 renal tumors.


METHODS
RFA was performed on 105 renal tumors in 97 patients, with a mean tumor size of 32 mm (11-68 mm). The mean patient age was 71.7 years (range, 36-89 years). The ablations were carried out under ultrasound (n = 43) or CT (n = 62) guidance. Imaging follow-up was by contrast-enhanced CT within 10 days and then at 6-monthly intervals. Multivariate analysis was performed to determine variables associated with procedural outcome.


RESULTS
Eighty-three tumors were completely treated at a single sitting (79%). Twelve of the remaining tumors were successfully re-treated and a clinical decision was made not to re-treat seven patients. A patient with a small residual crescent of tumor is under follow-up and may require further treatment. In another patient, re-treatment was abandoned due to complicating pneumothorax and difficult access. One patient is awaiting further re-treatment. The overall technical success rate was 90.5%. Multivariate analysis revealed tumor size to be the only significant variable affecting procedural outcome. (p = 0.007, Pearson chi(2)) Five patients had complications. There have been no local recurrences.


CONCLUSIONS
Our experience to date suggests that RFA is a safe and effective, minimally invasive treatment for small renal tumors.
Breen
David J
DJ
Department of Radiology, Southampton University Hospitals NHS Trust, Tremona Road, Southampton, Hampshire SO16 6YD, UK. david.breen@suht.swest.nhs.uk
Rutherford
Elizabeth E
EE
Stedman
Brian
B
Roy-Choudhury
Shuvro H
SH
Cast
James E I
JE
Hayes
Matthew C
MC
Smart
Christopher J
CJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000009:adverse effects / Q000379:methods*; D012086:Reoperation; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000009:adverse effects; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000009:adverse effects