title: Ultrasound-guided radiofrequency ablation for cT1a renal masses in poor surgical candidates: mid-term, single-center outcomes.
abstract: OBJECTIVE
  Surgical management of small renal masses can be challenging in frail patients and thus modalities such as radiofrequency ablation (RFA) have emerged as valid alternative options. The aim of the current study was to present mid-term oncological and functional results on a series of patients with cT1a renal cell carcinomas (RCCs) who were unfit for surgery and underwent RFA using ultrasound guidance under local anesthesia.
  
  
  METHODS
  Data from patients fulfilling the study selection criteria were retrospectively collected. RENAL nephrometry score was used for tumor description. Parametric tests were used for data analysis and survival curves were estimated using the Kaplan-Meier method.
  
  
  RESULTS
  Overall, 32 patients (mean±standard deviation age, 72.4 ± 7.6 years) with biopsy-proven RCCs (tumor size, 23.75 ± 10.44 mm and RENAL score, 5.28 ± 1.33) underwent 32 RFA sessions. Twenty-seven patients (84.4%) had low complexity masses and five patients had masses of intermediate complexity (15.6%) according to RENAL score categorization. Over a follow-up period of 22.1 ± 13.7 months, one case of primary treatment failure was recognized (primary technical success 97.0%), and overall, three patients were diagnosed with residual disease (primary technique effectiveness 90.6%). No major complications occurred during the postprocedure 90-day follow up, while no difference was found in serum creatinine and estimated glomerular filtration rate pre and post procedure. Patients with intermediate-complexity renal lesions had shorter time to recurrence in comparison to low-complexity masses (p = 0.002). All patients were alive at the time of study data analysis without diagnosed metastases.
  
  
  CONCLUSIONS
  Percutaneous RFA of small RCCs using ultrasound-based guidance under local anesthesia can be an effective alternative method for managing patients who are unfit for surgery.
authors: Department of Urology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Greece.
authors: Ioannis
authors: I
authors: Zachos
authors: Department of Urology, Faculty of Medicine, School of Health Sciences, University of Thessaly, University Hospital of Larissa, GR-41100 Larissa, Greece.
authors: Konstantinos
authors: K
authors: Dimitropoulos
authors: Department of Urology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Greece.
authors: Anastasios
authors: A
authors: Karatzas
authors: Department of Urology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Greece.
authors: Michael
authors: M
authors: Samarinas
authors: Department of Anesthesiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Greece.
authors: Argiro
authors: A
authors: Petsiti
authors: Department of Anesthesiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Greece.
authors: Vassilios
authors: V
authors: Tassoudis
authors: Department of Urology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Greece.
authors: Vassilios
authors: V
authors: Tzortzis
keywords: frail; radiofrequency ablation; renal cancer; small renal masses; ultrasound; unfit