CT-Guided Radiofrequency Ablation of T1a Renal Cell Carcinoma in Korea: Mid-Term Outcomes

Abstract

ObjectiveTo evaluate the mid-term outcomes of percutaneous radiofrequency ablation (RFA) treatment in patients with small (< 4 cm) renal cell carcinoma (RCC) in Korea.Materials and MethodsBetween 2010 and 2015, 51 patients (40 men and 11 women; median age, 57 years) with biopsyproven 51 RCC were treated using CT-guided RFA. All patients were clinically staged T1aN0M0 prior to RFA. The median tumor size and follow-up period were 2.1 cm (range, 1.0–3.9 cm) and 26 months (4–60 months), respectively. Local tumor progression, distant metastasis, primary and secondary effectiveness rates, and major complication rates were recorded. Estimated glomerular filtration rates (GFRs) between pre-RFA and last follow-up were compared using paired t tests. The 2-year recurrence-free survival rate was calculated using Kaplan-Meier survival analysis.ResultsOf the 51 patients, 2 (3.9%) experienced local tumor progression, and 1 (2.0%) had lymph node metastasis after the first RFA session. Primary and secondary effectiveness rates were 96.1% (49/51) and 100% (1/1), respectively. Only 1 patient experienced a major complication (uretero-pelvic stricture) after the second RFA session for treating a local tumor progression, and the major complication rate was 1.9% (1/52). The median pre-RFA and last follow-up GFRs were 87.1 mL/ min/1.73 m2 (14.2–142.7 mL/min/1.73 m2) and 72.0 mL/min/1.73 m2 (7.2–112.6 mL/min/1.73 m2), respectively (p < 0.0001). The 2-year recurrence-free survival rate was 96.0%.ConclusionCT-guided RFA is a safe and effective treatment in Korean patients with T1a RCC because of excellent mid-term outcomes.

Long-Term Follow-Up Outcomes after Percutaneous US/CT-Guided Radiofrequency Ablation for cT1a-b Renal Masses: Experience from Single High-Volume Referral Center

“…In 1997, Zlotta et al, reported the first use of image-guided radiofrequency ablation in the treatment of a renal cancer [23], and nowadays this technique is included as a potential treatment in several guidelines by urological and radiological societies [17,24,25]. At the present, the majority of literature on the topic is based on small retrospective study, generally with short follow-up, and clinical series are based on US or CT guided ablations [8][9][10][11][12][13][14][15]. One of the key technical aspects to improve the results of ablation is the reliability of the image guidance.…”

“…Among different ablative techniques, radiofrequency ablation (RFA) has been one of the first applied in the treatment of kidney cancer [8,10,11]. Ultrasound (US), providing real time visualization, represents the most widely used technique for guiding ablations in the abdomen, particularly in Europe and Asia [12,13], while computed tomography (CT) is preferred in several centers, mainly in the United States [14,15]. Combination of US and a cross-sectional imaging modality such as CT might improve the visualization during treatment and improve results and safety of the procedure [16][17][18].…”

Comparison of General Anesthesia and Conscious Sedation during Computed Tomography–Guided Radiofrequency Ablation of T1a Renal Cell Carcinoma

“…An interventional radiologist had experienced 7-year RFA experience before treating the first case in our study. All of these patients were also evaluated in another study in terms of midterm RFA outcomes [12].…”

Radiofrequency ablation for the treatment of knee osteoarthritis: present status and future perspectives

“…Radiofrequency ablation (RFA) is a relatively novel percutaneous technique, which has been widely applied for the treatment of several different medical conditions including cancers [2][3][4] and cardiac arrhythmias [5]. More recently, RFA has also been applied to treat chronic pain originating form benign conditions (e.g.…”