Image-guided laser ablation in the treatment of recurrence of renal tumours: technique and preliminary results

Federica Ferrari,Franco Orsi,Gianluca Maria Varano,Giovanni Mauri,Guido Bonomo,Luca Nicosia

doi:10.1186/s41747-019-0127-0

Federica Ferrari, Franco Orsi + Show 4 more

Open Access

https://doi.org/10.1186/s41747-019-0127-0

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Abstract

Abdominal recurrences of renal cell carcinoma (RCC) after surgery might represent a challenge for treatment, often requiring difficult surgeries or anticipated systemic therapy. Our aim is to illustrate a novel application of laser ablation for the treatment of abdominal recurrences of RCC. Patients with abdominal recurrences of renal cancer were treated under ultrasound/computed tomography guidance with a diode laser inserted into the lesion through a thin 21-G needle. A fixed 3-W power protocol was used, changing the illumination time according to lesion dimension and shape. Also, technical success, technical efficacy, local tumour progression, and major and minor complications were retrospectively analysed. Three patients were treated with image-guided laser ablation for abdominal recurrences of RCC. In all cases, it was possible to perform ablation as preoperatively planned and all three nodules (size of 6, 8, and 12 mm) were completely ablated with no evidence of residual enhancement after 6 weeks at contrast-enhanced CT. No minor or major complications were observed. No local tumour progression was reported up to 12 months from ablation. Image-guided laser ablation holds the potential to offer a minimally invasive treatment to patients with abdominal recurrence of RCC. Further studies are needed to evaluate the clinical role of this technique.

Highlights

Renal cell carcinoma (RCC) is a common urologic malignant lesion in adults and accounts for 2.6% of all cancers [1]
Difficult reoperation could be avoided and systemic therapy could be postponed by successful laser ablation of abdominal recurrences of renal tumours
In the form of radical or partial nephrectomy, is still considered the first choice of treatment for RCC [3], while image-guided thermal ablation is rapidly emerging as an effective alternative, with similar results, lower complications and lower costs [4,5,6,7]

Summary

Key points

Three patients with abdominal recurrence of renal tumours underwent image-guided laser ablation. All three treatments were successful, without any complications. No local tumour progression was reported up to 12 months from ablation. Difficult reoperation could be avoided and systemic therapy could be postponed by successful laser ablation of abdominal recurrences of renal tumours

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