title: Effectiveness and safety of computed tomography-guided radiofrequency ablation of renal cancer: a 14-year single institution experience in 203 patients.
abstract: OBJECTIVE
  To define effectiveness and safety of CT-guided radiofrequency ablation (RFA) of renal tumours and prognostic indicators for treatment success.
  
  
  METHODS
  Patients with a single treatment of a solitary, biopsy-proven renal tumour with intent to cure over a 14-year period were included (n = 203). Probability of residual disease over time, complication rates and all-cause mortality were assessed in relation to multiple variables.
  
  
  RESULTS
  Mean tumour size was 2.5 cm (range 1.0-6.0). Mean follow-up was 34.1 months (range 1-131). There was an increase in likelihood of residual disease for tumours ≥3.5 cm (P < 0.05), clear cell subtype of renal cell carcinoma (P ≤ 0.005) and maximum treatment temperature ≤70 °C (P < 0.05). There was a decrease in likelihood of residual disease for exophytic tumours (P = 0.01) and no difference based on age, gender, tumour location or type of radio freqency (RF) electrode used. Major complications occurred in 3.9 %. Median post-treatment survival was 7 years for patients with tumours <4 cm, and 5-year overall survival was 80 %. Probability of minor complication increased with tumour size (P = 0.03), as did all-cause mortality (P = 0.005).
  
  
  CONCLUSIONS
  CT-guided RFA is safe and effective for early-stage renal cancer, particularly for exophytic tumours measuring <3.5 cm. Overall 5-year survival with tumours <4 cm is comparable to partial nephrectomy.
  
  
  CONCLUSIONS
  • Prognostic indicators for success of CT-guided RFA of renal tumours are reported. • Tumour size ≥3.5 cm confers an increased risk for residual tumour. • Clear cell renal cell carcinoma subtype confers increased risk for residual tumour. • Tmax <70 °C within the ablation zone confers increased risk for residual tumour. • Exophytic tumours have a lower probability of residual disease.
authors.affiliation: Department of Radiology, Rhode Island Hospital, Alpert Medical School of Brown University, 593 Eddy St., Providence, RI, 02903, USA. jiannuccilli@lifespan.org.
authors.forename: Jason D
authors.initials: JD
authors.lastname: Iannuccilli
authors.affiliation: Department of Radiology, Rhode Island Hospital, Alpert Medical School of Brown University, 593 Eddy St., Providence, RI, 02903, USA.
authors.forename: Damian E
authors.initials: DE
authors.lastname: Dupuy
authors.affiliation: Department of Radiology, Rhode Island Hospital, Alpert Medical School of Brown University, 593 Eddy St., Providence, RI, 02903, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Beland
authors.affiliation: Department of Biostatistics, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI, 02903, USA.
authors.forename: Jason T
authors.initials: JT
authors.lastname: Machan
authors.affiliation: Department of Urology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI, 02903, USA.
authors.forename: Dragan J
authors.initials: DJ
authors.lastname: Golijanin
authors.affiliation: Department of Radiology, Rhode Island Hospital, Alpert Medical School of Brown University, 593 Eddy St., Providence, RI, 02903, USA.
authors.forename: William W
authors.initials: WW
authors.lastname: Mayo-Smith
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology; D017115:Catheter Ablation / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000601:surgery; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
keywords: Kidney neoplasm; Nephrectomy; Radiofrequency ablation; Renal cell carcinoma; Tumour ablation