title: Percutaneous CT-Guided Radiofrequency Ablation of Solitary Small Renal Masses: A Single Center Experience.
abstract: OBJECTIVE
  To analyze the outcome of patients undergoing percutaneous CT-guided radiofrequency ablation (RFA) of small renal masses (SRM) at a single center during a ten-year time period.
  
  
  METHODS
  Patient records of renal RFAs (07/2003 - 11/2013) were reviewed. Indications were SRM suspicious of malignancy on imaging and one of the following: severe comorbidity; old age; solitary kidney; impaired renal function; patient wish. Biopsy was performed at the time of RFA. Patients were excluded if no follow-up was available. Patient and procedural characteristics were recorded. Survival rates were calculated using the Kaplan-Meier's method and compared with log-rank or cox tests.
  
  
  RESULTS
  38 patients (16 females, mean age 70.0 years [range 52 - 87]) presenting with a solitary SRM were included in the study. Biopsy showed malignancy in 29 patients; 9 had benign tumors. 26 patients suffered from cardiovascular, respiratory or hepatic comorbidities. Technical success (complete ablation on first follow-up) was achieved in 95 % of cases. Two major complications (bowel perforation; hematothorax) occurred. The 3- and 7-year overall survival (OS) [any cause] rates were 73.4 ± 0.8 % and 50.3 ± 1.0 %, respectively (mean follow-up 54.6 months, range 1 - 127). 4 recurrences and 2 metastases were observed. The presence of comorbidities was the only independent predictor of OS. There was no difference in survival between patients with benign and malignant tumors.
  
  
  CONCLUSIONS
  RFA of SRM is successful in a large percentage of cases with a low complication rate and durable local control. As RFA is typically performed in multimorbid patients, overall survival seems to depend primarily on comorbidities rather than cancer progression. Key Points • RFA of SRM is technically successful in the majority of cases. • RFA leads to a high degree of local tumor control. • Post-RFA most patients ultimately die of comorbidities. • Overall survival post-RFA does not significantly differ between benign and malignant tumors in multimorbid patients.
authors.affiliation: Department of Radiology, University of Bonn, Germany.
authors.forename: C C
authors.initials: CC
authors.lastname: Pieper
authors.affiliation: Department of Radiology, University of Bonn, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Fischer
authors.affiliation: Department of Radiology, University of Bonn, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Strunk
authors.affiliation: Department of Radiology, University of Bonn, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Meyer
authors.affiliation: Department of Radiology, University of Bonn, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Thomas
authors.affiliation: Department of Radiology, University of Bonn, Germany.
authors.forename: W A
authors.initials: WA
authors.lastname: Willinek
authors.affiliation: Department of Urology, University of Bonn, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Hauser
authors.affiliation: Institute for Medical Biometry, Informatics and Epidemiology, University of Bonn, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Nadal
authors.affiliation: Department of Radiology, University of Bonn, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Schild
authors.affiliation: Department of Radiology, Johanniter GmbH, Johanniter Hospital Bonn, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Wilhelm
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome