Radiologically-guided thermal ablation of renal tumours

Abstract

Thermal ablation techniques for renal tumours have become the norm in surgically at-risk patients. These percutaneous treatments are locally effective, particularly for tumours measuring less than 4cm. Larger tumours may be treated by adapting the technique and strategy. Multidisciplinary discussion is essential before any decision, in order to decide on the most appropriate technique. Radiofrequency is simple, effective and inexpensive. Cryotherapy is more complex and should be preferred when the tumour is large or there is vascular or urinary tract contact. Microwaves can be used to treat larger tumours. Morbidity is low, but good knowledge of these techniques and of dissection is required to avoid injury to neighbouring digestive or urinary structures.

Nanotechnology for cancer treatment

“…These currently implemented thermal ablative approaches do not utilize NPs, and thus, implementation is based on macroscopic detection of metastatic lesions rather than on specific molecular recognition as is becoming increasingly possible using NP-mediated ablative approaches. Radiologic guidance can improve tumor specificity [101, 102] increasing the efficacy of cancer therapy. It is important to note that micrometastatic disease, particularly at sites distant from the primary tumor, is an extremely poor prognostic indicator (Figure 2).…”

Les traitements ablatifs dans le cancer du rein localisé : revue de la littérature en 2014

“…Seule une biopsie peut affirmer cette absence, mais elle reste invasive, or les cicatrices de radiofréquence évolue dans le temps [25].…”

Optimal management of renal cell carcinoma in the elderly: a review

“…With regard to complications of ablative techniques, the rates are between 4% and 37%, and most of them are bleeding, pain (usually temporary), pneumothorax, or thermal lesion of the digestive tract, or lesion of the urinary tract 53. For Klatte et al,52 incidence of perioperative complications was increased with PN compared with LCA, with 23.5% and 17%, respectively ( P < 0.001), and more important major complications occurred more frequently following PN compared with LCA (19.2% vs 10.2%).…”