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BJU Int. 2013 May;111(6):997-1005. doi: 10.1111/j.1464-410X.2012.11608.x. Epub 2013 Mar 19.

Radiofrequency ablation of renal tumours with clinical, radiographical and pathological results.

Author information

1
Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

Abstract

WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Radiological imaging is heavily relied on for follow up after renal ablative therapy. We show that while this is largely reliable, there are quantifiable false negative and false positive findings. A non-involuting zone of ablation should be considered for multisite-directed core biopsies even in the absence of detectable enhancement.

OBJECTIVE:

To evaluate our experience with radiofrequency ablation (RFA) for renal masses and to report on clinical, radiological and post-RFA biopsy results.

PATIENTS AND METHODS:

The study collected clinical, radiological and pathological data from 150 consecutive patients who were treated with RFA of a renal mass between 2002 and 2008 at a tertiary referral centre. Post-ablation biopsies were performed in patients with non-involuting lesions or suspicion of recurrence on imaging. Comparisons were performed using the Mann-Whitney U-test. Survival was estimated using the Kaplan-Meier method.

RESULTS:

Renal malignancy was found in 72.1% of patients based on the initial diagnostic biopsy. Median tumour size was 2.6 cm, 22.7% of patients had a solitary kidney, and most were central tumours. The mean follow-up period was 40.1 month. There was no recurrence in 96.7% of the entire cohort. Cancer-specific survival for 106 patients with sporadic, localized, biopsy proven renal malignancy was 100% at 38.5 months. Biopsies were obtained in 43 patients for a median of 21 months after RFA. Among 38 patients who had biopsy for non-involuting, non-enhancing zones of ablation, three (7.9%) were positive.

CONCLUSIONS:

Short-term cancer-specific survival after RFA remains excellent and most cases are successful based on a combination of imaging and post-ablation biopsies performed almost 2 years after treatment. There were four out of 150 (2.7%) patients who had recurrences with tissue confirmation; one of these patients was detected on imaging and three (2%) were radiologically occult. The absence of enhancement in the setting of non-involuting lesions is not always a guarantee of a successful ablation.

PMID:
23510233
PMCID:
PMC3637414
DOI:
10.1111/j.1464-410X.2012.11608.x
[Indexed for MEDLINE]
Free PMC Article

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