1527 RADIOFREQUENCY ABLATION OF SMALL RENAL MASSES: OVER 8 YEAR EXPERIENCE AT A SINGLE INSTITUTION

Abstract

You have accessJournal of UrologyKidney Cancer: Localized1 Apr 20111527 RADIOFREQUENCY ABLATION OF SMALL RENAL MASSES: OVER 8 YEAR EXPERIENCE AT A SINGLE INSTITUTION Scott Castle, Vladislav Gorbatiy, Nelson Salas, Watid Karnjanawanichkul, and Raymond Leveillee Scott CastleScott Castle Miami, FL More articles by this author , Vladislav GorbatiyVladislav Gorbatiy Miami, FL More articles by this author , Nelson SalasNelson Salas Miami, FL More articles by this author , Watid KarnjanawanichkulWatid Karnjanawanichkul Miami, FL More articles by this author , and Raymond LeveilleeRaymond Leveillee Miami, FL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1520AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES With the increased incidence of low stage renal cancers, thermal ablation technology has emerged as a viable treatment option. Current AUA guidelines include thermal ablation as a treatment modality in select individuals. We present an 8-year, single institution experience with radiofrequency ablation (RFA) of small renal masses. METHODS We reviewed our prospectively collected RFA database of patients with renal masses treated from Nov 2001 to Aug 2010 undergoing laparoscopic or CT guided percutaneous RFA with or without simultaneous peripheral fiber-optic thermometry (Lumasense, Santa Clara, CA). Data was collected for patient demographics, surgical outcomes, and clinico-pathologic outcomes. RESULTS A total of 291 patients (208 male, 83 female) aged 31–88 years (mean 67) with 308 renal tumors underwent laparoscopic (116) or percutaneous (192) RFA with CT guidance. 11 patients had more than 1 tumor ablated during surgery (11 Lap, 6 CT, one patient with 6 ablations), and 38 (13%) had no peripheral thermometry. 115 complications occurred in 73 patients, where 74, 16, 11, 4 were Clavien grade I, II, III, IV respectively. 155 Right-sided and 153 Left sided tumors had a mean size of 2.6cm (0.8–5.3). Intraoperative biopsy, prior to ablation, was performed in 304/308 (98.7%) tumors, with 204 (67%) being Renal Cell Carcinoma (RCC), 84 (28%) benign tumors, 14 (4.6%) with an indeterminate biopsy, and 1 biopsy with metastatic lung cancer. Patients were followed by contrast enhanced CT scans at 1 month, 6 months, and annually with a mean follow-up of 20.6 months (0.5–84). Nine patients were followed with a non-contrast MRI due to renal insufficiency. 14/204 (6.9%) patients with RCC had persistent enhancement on follow-up imaging. Of those, 10 patients underwent re-ablation with concurrent biopsy whereas 3 patients chose to undergo a re-biopsy, and one refused biopsy. Six patients had persistent RCC on biopsy. Biopsy proven recurrence rate was 2.9%. Two patients died due to metastatic RCC, and 6 of other causes. Cancer free survival rate was 99.0% at mean follow up of 20.6 months. Patients had a no change in renal function based on preoperative and postoperative eGFR. CONCLUSIONS RFA has shown to be clinically effective, nephron-sparing and safe the treatment of small renal masses. Our large cohort adds to the building evidence for the efficacy of RFA for small renal masses. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e613 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Scott Castle Miami, FL More articles by this author Vladislav Gorbatiy Miami, FL More articles by this author Nelson Salas Miami, FL More articles by this author Watid Karnjanawanichkul Miami, FL More articles by this author Raymond Leveillee Miami, FL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...