Abstract
This review will discuss how minimally invasive, image-guided radiofrequency (RF) tumor ablation [i.e., coagulating tumor using short-duration heating (<15 minutes) by directly applying temperatures >50 degrees C via needle electrodes] is being incorporated as a clinical tool for the treatment of renal cell carcinoma. RF ablation has been used to treat focal liver tumors. Potential benefits of this thermal therapy include reduced morbidity and mortality compared with standard surgical resection and the ability to treat nonsurgical patients. More recently, this technique has been introduced to treat focal renal tumors, particularly incidental lesions smaller than 3 cm in elderly patients and those with comorbid conditions. Other uses have included treatment in patients with von Hippel-Lindau syndrome and other diseases that predispose patients to multiple renal carcinomas, where renal parenchymal preservation is desired. Techniques, complications, and results will be discussed. Additionally, strategies that we are currently studying to improve RF outcomes and enable the potential treatment of larger tumors will be addressed. Most notably, recent data on increased coagulation achieved by combining RF ablation with antivascular/antiangiogenic therapies, such as arsenic trioxide, that reduce blood flow and promote heat retention are provided.
Highlights
Image-guided percutaneous radiofrequency (RF) ablation continues to gain attention as a viable treatment option for the focal destruction of solid tumors because it provides many potential advantages over surgical resection, including reduced morbidity, outpatient therapy, and the ability to treat poor surgical candidates
The greatest attention has been given to the potential of RF ablation for the treatment of colorectal metastases to the liver and to primary liver tumors, fueled in part by the significant morbidity and mortality associated with hepatic resection
A contributing factor includes the significant increase in the incidence of renal cell carcinoma (RCC), which, when coupled with improved understanding of RF techniques, has recently led many investigators to assess the feasibility and efficacy of RF ablation for renal tumors in select patient populations [7,8,9,10,11,12,13]
Summary
Image-guided percutaneous radiofrequency (RF) ablation continues to gain attention as a viable treatment option for the focal destruction of solid tumors because it provides many potential advantages over surgical resection, including reduced morbidity, outpatient therapy, and the ability to treat poor surgical candidates. In 2003, there were more than 31,000 new cases of RCC diagnosed in the United States [26], an incidence that has more than doubled since 1950 The reason for such an increase is partially attributable to widespread high-resolution diagnostic imaging, which has led to the serendipitous detection of small tumors in asymptomatic patients [27,28,29]. A less invasive approach would be welcome as an alternative to surgical tumor debulking that is practiced in conjunction with immunotherapy in patients presenting with stage IV disease and small primary tumors [36] These multiple rationales have led to a significant increase in the number of patients with RCC receiving RF ablation. No study has yet demonstrated a clear advantage of any one device [37]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Clinical cancer research : an official journal of the American Association for Cancer Research
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
