Percutaneous ablation of kidney tumors in nonsurgical candidates

Although resection currently remains the standard of care for renal carcinoma, the search for less invasive treatments has led to alternative surgical approaches. Even less invasive, and appropriate for many groups of patients, is percutaneous radiofrequency ablation, which induces tumor necrosis via lethal hyperthermia. Multiple series of renal tumors treated with percutaneous ablation in vivo and left in situ have been published; these series reveal that for small renal tumors, radiofrequency ablation results in complete necrosis at imaging in 79% to 100% of cases. Because current results come from tumors left in situ with short postablation follow-up, long-term results are necessary to compare outcomes to surgical standards. Complication rates are lower than those following partial nephrectomy. Future reports will shed light on the long-term outcomes of percutaneous ablation and the relative advantages and disadvantages of various technologies for thermal ablation.