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Cryotherapy and radiofrequency ablation: pathophysiologic basis and laboratory studies
Antonio Finelli1, John C Rewcastle, Michael A S Jewett
1Department of Surgical Oncology, Princess Margaret Hospital and University of Toronto, Ontario, Canada.
Current Opinion in Urology
|April 15, 2003
Summary
Minimally invasive cryoablation and radiofrequency ablation offer alternatives for small renal masses. Active thaw in cryoablation is effective, while radiofrequency ablation shows variable results and requires improved histological assessment for cell viability.
Area of Science:
- Urology
- Oncology
- Minimally Invasive Therapies
Background:
- Growing interest in minimally invasive treatments for small renal masses due to slow growth.
- Cryoablation and radiofrequency ablation are key energy-based minimally invasive options.
Purpose of the Study:
- Review recent clinical and laboratory studies on cryoablation and radiofrequency ablation for renal masses.
- Examine the scientific basis of current treatment protocols.
- Discuss potential changes to protocols based on new observations.
Main Methods:
- Review of recent clinical and laboratory studies.
- Analysis of data on cell death and tissue viability.
- Histological assessment of ablation techniques.
Main Results:
- Active thaw in cryoablation is as effective as passive thaw and reduces operative time.
- Radiofrequency ablation effectiveness for renal masses is inconsistent.
- Hematoxylin and eosin staining is insufficient for assessing radiofrequency ablation cell viability; nicotinamide adenine dinucleotide staining is recommended.
Conclusions:
- Cryoablation is well-understood for direct and indirect cell damage, with ongoing refinement of freezing parameters.
- Radiofrequency ablation effectively destroys cancerous tissue via coagulation necrosis, but targeting challenges lead to treatment failures.