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European Radiology
Published in: European Radiology 6/2016

01-06-2016 | Interventional

Effectiveness and safety of computed tomography-guided radiofrequency ablation of renal cancer: a 14-year single institution experience in 203 patients

Authors: Jason D. Iannuccilli, Damian E. Dupuy, Michael D. Beland, Jason T. Machan, Dragan J. Golijanin, William W. Mayo-Smith

Published in: European Radiology | Issue 6/2016

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Abstract

Objectives

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.

Key points

• 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.
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Metadata
Title
Effectiveness and safety of computed tomography-guided radiofrequency ablation of renal cancer: a 14-year single institution experience in 203 patients
Authors
Jason D. Iannuccilli
Damian E. Dupuy
Michael D. Beland
Jason T. Machan
Dragan J. Golijanin
William W. Mayo-Smith
Publication date
01-06-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 6/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-4006-7

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