title: Laparoscopic radiofrequency ablation with intraoperative contrast-enhanced ultrasonography for T1bN0M0 renal tumors: initial functional and oncologic outcomes.
abstract: OBJECTIVE
  To assess the functional and oncologic outcomes of laparoscopic radiofrequency ablation (RFA) with intraoperative contrast-enhanced ultrasonography in treatment of T1b renal tumors.
  
  
  METHODS
  We performed a retrospective review of 51 patients with unilateral T1b renal tumors who underwent laparoscopic RFA from January 2007 to April 2012 with a mean follow-up of 31.5 months. The tumors were laparoscopically dissected and ablated with cool-tip RFA system under the guidance of contrast-enhanced ultrasound. Routine follow-up included contrast-enhanced computed tomography/magnetic resonance imaging (CT/MRI) and renal function tests.
  
  
  RESULTS
  Mean diameter of the treated renal tumors was 5.1 cm (range 4.1-6.4 cm). Initial ablation success rate was 46/51 (90.2%). Of five incompletely ablated patients, four experienced up to two additional sessions of percutaneous RFA and achieved complete ablation. After at least 12 months contrast-enhanced CT/MRI follow-up after RFA, one patient experienced local tumor recurrence and another developed pulmonary and bone metastases. The 3-year disease-free survival in patients with biopsy-proven cancer was 85.7%. There was no significant difference between the estimated glomerular filtration rate (eGFR) pre- and post-RFA. Mean change in eGFR following RFA was -2.2  mL/minute. No patients required dialysis in the periprocedural period. Major complications (≥Grade 3) only developed in two (3.9%) cases.
  
  
  CONCLUSIONS
  Our initial experience with this technique in T1b renal tumors was favorable with good renal function preservation and oncologic outcomes. It may be a good alternative to partial nephrectomy for selected T1b renal tumors.
authors.affiliation: The Affiliated Drum Tower Hospital of Nanjing University , School of Medicine, Nanjing, People's Republic of China .
authors.forename: Rong
authors.initials: R
authors.lastname: Yang
authors.forename: Huibo
authors.initials: H
authors.lastname: Lian
authors.forename: Gutian
authors.initials: G
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Weidong
authors.initials: W
authors.lastname: Gan
authors.forename: Xiaogong
authors.initials: X
authors.lastname: Li
authors.forename: Xiang
authors.initials: X
authors.lastname: Yan
authors.forename: Shiwei
authors.initials: S
authors.lastname: Zhang
authors.forename: Xiaozhi
authors.initials: X
authors.lastname: Zhao
authors.forename: Hongqian
authors.initials: H
authors.lastname: Guo
mesh_terms: D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome; D014463:Ultrasonography