Thermal ablation of small renal masses:  intermediate outcomes from a Canadian center.
BACKGROUND
Cryoablation (CA) and radio frequency ablation (RFA) are nephron sparing procedures that destroy renal tissue in situ rather than by surgical removal.  Both thermal ablative techniques are advocated in select patient population with a small renal mass and multiple comorbidities which may preclude major surgery.  Unfortunately long term oncologic outcomes of these procedures are unknown.


METHODS
We report oncologic outcomes following CA and RFA in patients with small renal masses, from a single center, during a 48 month follow up period.  Thirty patients underwent thermal ablation of a small renal mass, 7 with RFA and 23 with CA.


RESULTS
Median tumor size on preoperative CT was 2.6 cm ± 0.87 cm.  Four patients experienced a loco-regional treatment failure and underwent subsequent radical nephrectomy.  Two patients were diagnosed with metastatic renal cell cancer in the follow up period.  Six patients died during the follow up period, five from unrelated cause and one from metastatic RCC (overall survival 80%, RCC-specific survival 96%).


CONCLUSIONS
This study demonstrates low RCC recurrence rates and in combination with previously published reports supports the effectiveness of thermal ablation therapy as primary therapeutic option in a very specific patient population.
Division of Urology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada.
Petar
P
Erdeljan
Mrinal
M
Dhar
Geoff
G
Wignall
Roman
R
Kozak
Stephen E
SE
Pautler
D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation; D003452:Cryosurgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000401:mortality / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000601:surgery; D009392:Nephrectomy; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome