Long-Term Oncological and Overall Outcomes of Percutaneous Radio Frequency Ablation in High Risk Surgical Patients With a Solitary Small Renal Mass

Levinson, Adam W.; Su, Li-Ming; Agarwal, Devesh; Sroka, Myrna; Jarrett, Thomas W.; Kavoussi, Louis R.; Solomon, Stephen B.

doi:10.1016/j.juro.2008.04.031

Cited by 161 publications

(87 citation statements)

References 20 publications

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“…Although long-term data are not yet available with these modalities, intermediate-term data demonstrates favorable recurrence and progression free survival. 11,12,13,14 The role of AS in the treatment of small RCN is well known and is considered a recommendation for elderly patient and in patients that are considered to be at high surgical risk. AS can be considered an option for healthy patients who have been informed of all treatment options and who insist on avoiding surgical extirpation or ablation.…”

Section: Review Of Management Options For the Ct1 Renal Massmentioning

confidence: 99%

“…Several series on AS have supported these findings and in general, the consensus is that ITS is not a predictive factor for an increase in GR or malignant potential in renal masses <4cm. 14,[18][19][20][21] Tumor growth rates in large single institution series and meta-analyses have been shown to be reasonably low (0.28-0.34cm/year) for most tumors. 6,7 Kunkle and co-workers concluded that there was no difference in the incidence of malignancy between tumors with zero growth versus those that do grow.…”

Section: Active Surveillance: How To Decidementioning

confidence: 99%

“…29 The majority of series that report metastatic disease indicate that there was interval growth in the primary lesion and that most tumors displayed an accelerated growth rate. 7,14,21,23,30,31,32 Therefore, an increased growth rate may be associated with progression to metastatic disease.…”

Section: Outcomes After Long-term Follow-upmentioning

confidence: 99%

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Active Surveillance for Renal Cortical Neoplasms

et al. 2010

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Section: Review Of Management Options For the Ct1 Renal Massmentioning

confidence: 99%

Section: Active Surveillance: How To Decidementioning

confidence: 99%

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Active Surveillance for Renal Cortical Neoplasms

et al. 2010

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“…The recurrence-free survival rate was 90.3 % in a study that followed up SRMs in single kidneys treated with RFA for over 40 months [36]. Stern et al published in their study disease-specific survival following RFA in T1a lesions of 93.4 % with a mean followup of 30 months.…”

Section: Oncological Outcome Of Rfamentioning

confidence: 99%

Non-Surgical Ablative Therapy for Management of Small Renal Masses—Current Status and Future Trends

Farrag

Sriprasad

2016

Indian J Surg Oncol

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A large number of small renal masses (SRMs) with size less than 4 cm are being identified due to advances in diagnostic imaging. As the natural history of these tumours remains unknown, there is no reliable way to predict their behaviour or future growth. Although, partial nephrectomy is the gold standard for treatment of these tumours, ablative non-surgical therapies such as cryoablation and radiofrequency ablation provide a less invasive option of treatment with comparable oncological outcomes. In this systematic review, the principle, indications, methods of treatment, oncological control, complication and renal function of ablative therapies are critically reviewed. Cryotherapy utilizes the principle of inducing tissue destruction by freezing and thawing using argon and helium gasses, respectively. Radiofrequency ablation (RFA) works on the principle of tissue heating. Ablative treatments are particularly useful in the elderly patients, those with comorbidities or in patients with SRMs in solitary kidneys or renal impairment. Ablative therapies have less procedurerelated complications and have promising medium-term oncological outcome. Longer-term results are accumulating. Cryotherapy may be a better modality for oncological control than RFA. Ablative therapy has emerged as a viable treatment options for SRMs with recurrence free survival rates approaching that of extirpative surgery. However, there is no consensus in the literature on the best selection criteria and this needs further refinement. Prospective long-term data with regards to oncological control is still needed

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“…In a study that followed up SRMs in single kidneys treated with RFA for over 40 months [32], the recurrence free survival rate was 90.3%. Disease specific survival rate following RFA in T1a lesions was reported as 93.4% by Stern et al [33] in their study with a mean follow up of 30 months.…”

Section: Oncological Outcome Of Rfamentioning

confidence: 99%

Ablative Therapy in 2016 for Small Renal Masses

Ian¹,

Farrag²,

Sriprasad³

2017

UNOAJ

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Introduction: Incidental diagnosis of small renal masses (SRMs), less than 4 cm in size, is increasing due to the widespread use of different forms of diagnostic imaging. The natural history of these tumours remains unknown and there is no reliable way to predict their behaviour or growth. Partial nephrectomy is currently the gold standard in the treatment of these tumours. However, the more minimally invasive, non-excisional, ablative therapies such as cryoablation (CRA) and radiofrequency ablation (RFA) are providing comparable oncological outcomes.Methods: This article critically reviews the principles, indications, modalities of treatment, oncological outcome, complication and effect on renal function, of the different ablative therapies.Results: Cryotherapy induces tissue ablation by freezing and thawing using argon and helium gases respectively.RFA ablates the tissue by heating. These Ablative treatments for SRMs are particularly indicated in the elderly patients, those with co-morbidities, in patients with solitary kidneys and in those with impaired renal function. The procedure related complication rate with ablative therapies are lower. These procedures have a promising medium term oncological outcome, while longer-term results are awaited. It appears that Cryotherapy may be evolving as a better modality for oncological control than RFA. Conclusion:The Ablative therapies for SRMs are emerging as viable treatment options with recurrence free survival rates approaching that of extirpative surgery. However, there is currently no consensus in the literature on the best selection criteria for this form of treatment. With further refinement of selection criteria and more prospective long-term data on the oncological outcome, these ablative methods would have a promising future in the management of SRMs.

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Long-Term Oncological and Overall Outcomes of Percutaneous Radio Frequency Ablation in High Risk Surgical Patients With a Solitary Small Renal Mass

Cited by 161 publications

References 20 publications

Active Surveillance for Renal Cortical Neoplasms

Active Surveillance for Renal Cortical Neoplasms

Non-Surgical Ablative Therapy for Management of Small Renal Masses—Current Status and Future Trends

Ablative Therapy in 2016 for Small Renal Masses

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