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CardioVascular and Interventional Radiology

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01-10-2014 | Clinical Investigation

T1a as the Sole Selection Criterion for RFA of Renal Masses: Randomized Controlled Trials versus Surgery Should Not Be Postponed

Authors: Andrea Veltri, Carlo Gazzera, Marco Busso, Federica Solitro, Giorgina B. Piccoli, Bruno Andreetto, Irene Garetto

Published in: CardioVascular and Interventional Radiology | Issue 5/2014

Abstract

Purpose

To evaluate the long-term effects of radiofrequency ablation (RFA) of renal masses (RM) and compare them with surgery.

Methods

A total of 203 RM (193 malignant; mean size 30 mm) in 137 patients (95 male subjects; average age 64 years) underwent RFA. Complications and technique effectiveness were evaluated. Overall survival, cancer-specific survival, and disease-free survival were calculated (mean follow-up time 39 months). Predictors for complications, technique effectiveness, and survival were investigated.

Results

Seventeen (8.4 %) adverse events were recorded (2 % major complications). Exophytic development and smaller size were protective against adverse events. Complete ablation was obtained in 87 % RM (93 % ≤3 cm, 89 % ≤4 cm). T1a threshold was a positive predictor for complete ablation and central location a negative one. Three- and 5-year overall survival were 84 and 75 %; cancer-specific survival 96 and 91 %; and disease-free survival 80 and 75 %. Considering only the 79 patients with newly diagnosed renal cell carcinoma, T1a disease stage resulted a positive predictor for both overall survival (87 and 83 % at 3 and 5 years) and cancer-specific survival (100 % at 5 years).

Conclusion

RFA of noncentral small RM is safe and effective, and it provides favorable long-term oncological outcomes. Selection criteria for RFA can also include T1a renal cell carcinoma in patients without surgical contraindications, even though randomized controlled trials are needed to establish the best treatment.

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Title: T1a as the Sole Selection Criterion for RFA of Renal Masses: Randomized Controlled Trials versus Surgery Should Not Be Postponed
Authors: Andrea Veltri
Carlo Gazzera
Marco Busso
Federica Solitro
Giorgina B. Piccoli
Bruno Andreetto
Irene Garetto
Publication date: 01-10-2014
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 5/2014
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-013-0812-y

At a glance: The STEP trials

Springer Medicine

T1a as the Sole Selection Criterion for RFA of Renal Masses: Randomized Controlled Trials versus Surgery Should Not Be Postponed

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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