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Hypertonic saline-augmented radiofrequency ablation of the VX-2 tumor implanted in the rabbit kidney: a short-term
Ravi Munver1, Chris B Threatt, Fernando C Delvecchio
1Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Objectives:
The increased incidental detection of small (less than 4 cm) renal tumors has stimulated investigations of minimally invasive therapies. Radiofrequency energy is a relatively new and evolving technology that has been used for a variety of experimental and clinical applications. We evaluate the efficacy of hypertonic interstitial saline-augmented radiofrequency therapy to ablate a malignant VX-2 tumor implanted in a rabbit kidney, as measured by the completeness of tumor destruction and progression to metastasis.
Methods:
The VX-2 tumor was surgically implanted into the left lower pole parenchyma of 18 New Zealand white rabbit kidneys. Ten days after implantation, hypertonic interstitial saline-augmented radiofrequency ablation was performed (n = 12) using a radiofrequency therapy system (RFT, United States Surgical Corp.). A sham operation was performed on a control group (n = 6). Animals were humanely killed at 5, 10, and 15-day intervals, and the clinical response and effect of radiofrequency energy on the malignant renal tissue was assessed.
Results:
No postoperative complications were encountered. The mean size of the implanted VX-2 tumor was 1.87 cm2. Kidneys in the treated group exhibited marked destruction of tumor tissue. Histologic analysis revealed coagulative necrosis of both malignant and normal renal tissue in the treated group. Three rabbits (1 control, 2 treated) died of metastatic disease.
Conclusions:
Coagulative necrosis of renal parenchyma and tumor tissue was clearly demonstrated after radiofrequency ablation using the RFT system. The aggressive growth pattern of the VX-2 tumor often resulted in progression to metastatic disease while precluding complete tumor ablation. Hypertonic saline-augmented radiofrequency ablation is a promising new technology for the management of small, locally confined, renal tumors and has the potential for use with a minimally invasive approach.
Insights
Hypertonic saline-augmented radiofrequency ablation effectively destroyed VX-2 renal tumors in rabbits, showing promise for minimally invasive treatment of small kidney cancers. Further studies are needed to address tumor progression and metastasis.
Area of Science:
- Oncology
- Nephrology
- Minimally Invasive Surgery
Background:
- Increased detection of small renal tumors necessitates novel, less invasive treatment options.
- Radiofrequency (RF) energy is an evolving technology with diverse clinical applications.
- Hypertonic interstitial saline augmentation is explored to enhance RF ablation efficacy.
Purpose of the Study:
- To evaluate the efficacy of hypertonic saline-augmented RF therapy in ablating VX-2 tumors in rabbit kidneys.
- To assess tumor destruction completeness and the rate of metastasis post-ablation.
Main Methods:
- VX-2 tumors were implanted in 18 rabbit kidneys.
- Hypertonic saline-augmented RF ablation was performed on 12 rabbits; 6 received a sham operation.
- Animals were euthanized at 5, 10, and 15 days for assessment.
Main Results:
- RF ablation demonstrated marked destruction of tumor tissue and coagulative necrosis.
- Both malignant and normal renal tissues showed necrosis in the treated group.
- Metastatic disease occurred in 3 rabbits (1 control, 2 treated).
Conclusions:
- Hypertonic saline-augmented RF ablation effectively caused coagulative necrosis of renal tumors.
- The aggressive nature of VX-2 tumors can lead to metastasis, challenging complete ablation.
- This technique shows promise for minimally invasive management of small, localized renal tumors.