Radiofrequency ablation safe, effective for small renal masses
Treatment with radiofrequency ablation (RFA) yields good long-term oncologic outcomes in patients with small renal masses but not in those with tumours >3 cm, a study has shown.
Researchers reviewed the medical records of 106 patients with renal tumours who underwent RFA. None of the patients had familial renal cell carcinoma syndromes. Outcomes examined included disease recurrence, disease-free survival (DFS), metastasis-free survival (MFS), cancer-specific survival (CSS) and overall survival (OS).
There were 112 tumours treated in total, with the mean size being 2.5 cm. Initial technical success was achieved in 97 percent of cases.
During a median follow-up of 79 months, a total of 10 recurrences occurred. Kaplan-Meier analysis revealed that DFS and CSS rates at 6 years were 89 percent and 96 percent, respectively. When analysis was stratified according to tumour size, DFS dropped to 68 percent for tumours >3 cm.
In the subgroup of patients with available 10-year follow-up data, actual rates of DFS, CSS and OS were 82 percent, 94 percent and 49 percent, respectively. None of the patients had recurrence after 5 years.
Currently, consensus recommendation states that smaller renal tumours should be treated with minimally invasive techniques to preserve renal function and avoid unnecessary surgical removal of the entire kidney. RFA, a recognized technique for treating small renal tumours, uses a high-frequency, alternating current within the targeted tissue to initiate ionic agitation generating frictional heat, which leads to cancer cell destruction when the temperatures exceed 60° C. [BJU Int 2014;113:416-428]