Laparoscopic Radiofrequency Ablation of Small Renal Tumors: Long-Term Oncologic Outcomes

Abstract

Unlike percutaneous radiofrequency ablation (RFA) of small renal tumors, there are limited data assessing the long-term efficacy of laparoscopic RFA. Although the ablation cannot be visualized as reliably as with cryoablation, laparoscopic RFA allows for improved mobilization and placement of probes under direct vision. We reviewed our experience with laparoscopic RFA to assess long-term oncologic outcomes. We performed a retrospective study of all patients who had undergone laparoscopic RFA for pT1a renal tumors from April 2000 to April 2010. Demographic, clinical, and radiologic data were assessed to determine indications and evidence for recurrence of disease. Radiologic recurrence was defined as any new enhancement (>10 HU) after absence of enhancement on initial negative 6-week computed tomography. Data were available for 79 patients who had 111 small renal masses treated over the 10-year period. The median tumor diameter was 2.2 cm and intraoperative biopsy identified renal cell carcinoma in 77%. The median follow-up was 59 months with an estimated 5-year recurrence-free survival of 93.3%. The overall rate of complications was 8.8% with a 3.8% rate of major complications. Long-term experience with laparoscopic RFA demonstrates that it is a safe and effective option for the treatment of small renal tumors. Five-year oncologic outcomes appear to be comparable to extirpation.