Results of radiofrequency kidney tumor ablation: renal function preservation and oncologic efficacy.
OBJECTIVE
Radiofrequency ablation (RFA) is increasingly finding a place in the treatment of small renal masses (SRM). RFA may be able to provide better renal preservation, while achieving appropriate cancer control. This investigation takes a critical look at pertinent aspects of RFA principles and reviews oncological and renal function outcomes.


METHODS
A review of the most current English literature using a PubMed search was done. Oncological and renal function outcomes were reviewed from selected articles published between 2003 and 2009. Oncological outcome was determined by "single treatment" success rate at first follow-up and "After single treatment" success rate after first follow-up. Renal function outcome was determined by either change in creatinine, creatinine clearance, or GFR after RFA.


RESULTS
The mean tumor size was 2.5 cm for 16/17 studies. Average mean and median follow-up was 23.3 months in 13/17 studies and 19.8 months for 4/17 studies. "Single Treatment" success rates of 90-100% (average = 97.2%) were noted in 13 studies. Average increase in serum creatinine was +0.14 mg/dL in four studies. Serum creatinine and creatinine clearance change in one solitary kidney study was +11 mmol/L and -8 mL/min., respectively.


CONCLUSIONS
RFA is fast emerging as a safe and efficacious treatment for small renal masses. Compared to extirpative treatment options, RFA seems to provide the lowest rate of renal impairment, while providing acceptable rates of tumor ablation. As long-term results emerge, this may become one of the treatment modalities for renal tumors in patients with solitary kidneys and renal impairment.
Salas
Nelson
N
Joint Bioengineering and Endourology Developmental Surgical Laboratory, Division of Endourology, Laparoscopy, and Minimally-Invasive Surgery, Department of Urology, University of Miami Miller School of Medicine, 1400 NW 10th Ave, Suite 509, Miami, FL 33136, USA.
Ramanathan
Rajan
R
Dummett
Scott
S
Leveillee
Raymond J
RJ
D017115:Catheter Ablation / Q000009:adverse effects; D003404:Creatinine / Q000097:blood; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007668:Kidney / Q000502:physiology* / Q000601:surgery; D007680:Kidney Neoplasms / Q000601:surgery*; D016896:Treatment Outcome
D003404:Creatinine
J Endourol. 2001 Aug;15(6):629-40
11552790
AJR Am J Roentgenol. 2003 Jun;180(6):1509-13
12760910
Cancer Control. 2007 Jul;14(3):205-10
17615525
J Endourol. 2009 Jul;23(7):1099-105
19530948
AJR Am J Roentgenol. 2007 Aug;189(2):429-36
17646471
Urology. 2000 Nov 1;56(5):872-5
11068326
Radiology. 2004 Sep;232(3):835-45
15333798
J Urol. 2009 Oct;182(4):1271-9
19683266
J Urol. 2009 Nov;182(5):2150-7
19758655
J Urol. 2004 Jul;172(1):45-8
15201734
J Urol. 2008 Jan;179(1):75-9; discussion 79-80
17997440
J Endourol. 2007 Aug;21(8):807-13
17867933
BJU Int. 2008 Mar;101(6):707-11
18205858
J Endourol. 2008 Jun;22(6):1261-7
18484892
Urology. 2005 May;65(5):877-81
15882715
Urology. 2001 May;57(5):976-80
11337311
J Urol. 2008 Aug;180(2):499-504; discussion 504
18550123
Acta Radiol. 2005 Apr;46(2):208-14
15902899
Eur Radiol. 2005 May;15(5):960-7
15756553
J Vasc Interv Radiol. 2005 May;16(5):679-88
15872323
Urology. 2006 Nov;68(5):983-7
17095059
J Endourol. 2006 Aug;20(8):569-73
16903817
BJU Int. 2007 Aug;100(2):287-90
17617136
AJR Am J Roentgenol. 2005 Jul;185(1):64-71
15972400
Eur J Radiol. 2010 Mar;73(3):652-6
19181470
BJU Int. 2010 Feb;105(4):496-500
19681900
Rofo. 2004 Mar;176(3):324-9
15026944
J Endourol. 2003 Oct;17(8):563-77
14622475