Incomplete Renal Tumor Destruction Using Radio Frequency Interstitial Ablation

Michaels, Mike J.; Rhee, Harrison K.; Mourtzinos, Arthur; Summerhayes, Ian C.; Silverman, Mark L.; Libertino, John A.

doi:10.1016/s0022-5347(05)64155-9

Cited by 137 publications

(56 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Another important point about biopsy is that some researchers have discussed post-ablative biopsy to confirm the adequacy of a radiographic definition of ablative success [28,29]. However, most of these researchers have used hematoxylin and eosin staining to assess post-treatment biopsies, which is inadequate for assessing cellular viability, as the heat denaturation during ablation results in preservation of the cellular formation [30,31].…”

Section: Discussionmentioning

confidence: 99%

Management of renal tumors in Von Hippel-Lindau disease by percutaneous CT fluoroscopic guided radiofrequency ablation: preliminary results

et al. 2011

View full text Add to dashboard Cite

We evaluated the feasibility and safety of percutaneous radiofrequency (RF) ablation of renal cell carcinomas (RCCs) in patients with Von Hippel-Lindau (VHL) disease. A total of 12 RCCs were treated by RF ablation in 7 patients with VHL disease. RF electrodes were placed under CT fluoroscopic guidance with conscious sedation. Technical success, technical effectiveness (disappearance of tumor enhancement), local tumor progression, complications and change in the estimated glomerular filtration rate (eGFR) were evaluated. A total of 9 sessions were undertaken. All procedures were performed with a planned protocol with a technical success rate of 100%. Tumor enhancement disappeared in all 12 tumors indicating a technical effectiveness rate of 100%. Local tumor progression was not found in any patient during the mean follow-up of 22 ± 11 months (range 12-46 months). There were no complications related to the RF procedures. The mean eGFR decreased from 65.3 ± 10.9 ml/min (range 48.5-77.5 ml/min) to 60.3 ± 11.3 ml/min (range, 45.8-73.4 ml/min, P < 0.03). The mean percentage decrease in eGFR after the last ablation was 7.6% (range 0-21.6%). Renal RF ablation is a safe and effective treatment for renal tumours that may allow patients with VHL disease to avoid major surgical interventions.

show abstract

Section: Discussionmentioning

confidence: 99%

Management of renal tumors in Von Hippel-Lindau disease by percutaneous CT fluoroscopic guided radiofrequency ablation: preliminary results

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Local efficacy of RFA is the most controversial topic: while some studies on lesions treated with RFA and then resected immediately or within a short period assert that necrosis induced by the treatment is often incomplete [29,30], others demonstrate that tissue destruction can be complete [31,32]. These differences can reflect the scarce standardization of the procedure, which is performed with different ablation systems and techniques (single or multiple-electrode arrays, cooled or hooked needles, dry or wet-tip probes; varying power and time settings; temperature-or impedance-based protocols) [15].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous US-guided RF thermal ablation for malignant renal tumors: preliminary results in 13 patients

et al. 2004

View full text Add to dashboard Cite

Minimally invasive treatment for small renal cell carcinoma (RCC) can be necessary in selected patients and, anyway, is desirable. In situ ablation techniques, including RFA, have been developed. The aim of this study is to evaluate the feasibility, safety and short-term local effectiveness of percutaneous US-guided RFA in a small series, as well as mid-term patient outcome. Thirteen patients with a total of 18 tumors (17 small lesions, 35 mm in size or less, and a larger one, 75 mm in size) underwent 19 RFA sessions. Seven patients had a solitary kidney, and three suffered from VHL disease, too. We treated four lesions in a patient with a bilateral tumor. In another patient, three lesions were ablated. Seventeen tumors were RCC; one was a metastasis from lung cancer. Eight lesions were parenchymal, six exophytic, two parenchymal/exophytic, one parenchymal/central and one central. A monopolar RF system with multitined expandable electrode needles was used. The 35-mm lesion underwent two sessions; the 75-mm lesion was treated with transcatheter arterial embolization before RFA. Tumors with complete loss of contrast enhancement at short-term CT (or MR) were considered successfully treated. Percutaneous US-guided RFA was always feasible without major complications. The success rate after a single treatment in tumors less than 35 mm in size was 88.2% (15/17) and rose to 94.1% (16/17) after the second treatment of the largest lesion. After a mean 14-month follow-up, no successfully treated lesions recurred locally. Only the patient with metastasis from lung cancer died from disease progression in a further location, while all other patients are alive, with renal function still sufficient to avoid dialysis. US guidance allows an easy and safe percutaneous approach for RFA of small non-parahilar RCC. The treatment is locally effective and can be proposed as a minimally invasive therapy for patients with contraindications to surgery or to those expressing an informed consent. Based on the results of this study and of the literature, mid-term results on the clinical usefulness are very encouraging.

show abstract

“…Michaels et al [25] from the Lahey Clinic also reported unfavorable outcomes related to RFA treatment. This group performed open RFA for 15 patients with a total of 20 tumors (mean, 2.4 cm in size) followed by partial nephrectomy.…”

Section: Clinical Resultsmentioning

confidence: 99%

Update on minimally invasive approaches to kidney tumors

Hwang

Walther²

2004

Curr Urol Rep

View full text Add to dashboard Cite

Renal tumors are being detected at increasing rates because of widespread use of modern imaging techniques such as ultrasonography and computed tomography. Typically, these tumors, many of which are discovered incidentally, tend to be small and are confined to the kidney. Advances in ablative and imaging technology have led to the application of minimally invasive therapy in the treatment of small renal tumors. Although still evolving as a cancer treatment, minimally invasive treatment potentially offers several advantages over conventional open renal surgery: shorter convalescence, improved cosmesis, reduced postoperative pain, and renal preservation. This article reviews the status and recent progress of minimally invasive approaches to renal neoplasm.

show abstract

Incomplete Renal Tumor Destruction Using Radio Frequency Interstitial Ablation

Cited by 137 publications

References 18 publications

Management of renal tumors in Von Hippel-Lindau disease by percutaneous CT fluoroscopic guided radiofrequency ablation: preliminary results

Management of renal tumors in Von Hippel-Lindau disease by percutaneous CT fluoroscopic guided radiofrequency ablation: preliminary results

Percutaneous US-guided RF thermal ablation for malignant renal tumors: preliminary results in 13 patients

Update on minimally invasive approaches to kidney tumors

Contact Info

Product

Resources

About