Percutaneous radiofrequency ablation of renal tumours: 29-month mean follow-up results of 118 patients
Keywords: radiofrequency ablation, survival, observation, fiducial markers
AbstractBackground. Percutaneous radiofrequency ablation (RFA) is a minimally invasive method of treatment based on thermal effects. This retrospective study aimed to clarify percutaneous RFA of kidney tumors – performance, extremeness and 5-year survival in patients with small renal tumors in a single center. Materials and methods. Between September 2003 and December 2012, a total of 118 patients underwent percutaneous RFA of renal tumors. During more than 9 years period 144 RFA procedures were performed. Tumors were verified by biopsy. We used 3 RFA techniques: RFA under ultrasound control only (US), ultrasound guided RFA with CT navigation (US/CT) and ultrasound guided RFA with CT navigation, fiducial markers placed around the kidney tumor before the treatment (US/CT/FM). RFA electrodes were one and three. Patients were followed up regularly by CT with contrast enhancement. Results. The mean patient age was 68.72 years (range 28 to 86). The mean tumor size was 2.8 cm (range 1 to 5.4). The mean follow-up time was 29 months (1–111 months). Radical dependence on technical procedures: only US 39 (66.1%), US/CT 18 (94.7%), US/CT/FM 37 (92.5%), p = 0.001. Radical differences between using one and three electrodes: 39 (66.1%) and 55 (93.2%), p < 0.05. 17 patients (14%) presented with complications: haematomas 12 (10%), severe bleeding 2 (1.7%), ureteral stricture 1 (0.8%), urinoma 1 (0.8%) and dysuria 1 (0.8%). 27 patients of the cohort have died till January 2013. Survival analysis showed that the 2-year survival probability was 84%, 5-year survival was 57%. Conclusions. In this study the most radical renal tumor RFAs were done with US/CT and with US/CT/FM. RFA is more radical when performed using three electrodes. Serious RFA complications are rare.
Surgery / Oncology