Radiofrequency ablation of renal tumors in patients unfi t for surgery. Our experience

To evaluate the feasibility and safety of the minimally invasive percutaneous technique radiofrequency ablation (RFA) in patients with small renal cell carcinomas (RCCs) who are unfit for surgery.

From January 2008 to November 2009, 7 patients (5 males and 2 females, median age 78 years) with small RCCs were treated with RFA. The indications for RFA were either inoperability due to high cardiovascular and pulmonary risk or a high probability of complete renal failure after nephrectomy. Exclusion criteria were tumor size larger than 6 cm and the localization of the tumor within the renal pelvis.

All RFAs were technically successful in terms of complete tumor ablation and all procedures could be done under conscious sedation. Complications after RFA included transient rise in plasma creatinine in 2 patients and hydrocalyx at 18 months in one. The mean hospital stay was 3.14 days (range 2-5).

RFA has limitations such as an uncertain long-term oncological result and need for strict follow up. Physicians must be aware of these limitations and present them clearly to the patients. It is a safe treatment modality that, with longer follow-up, could play a more important role in the care of patients with renal masses due to its potential for decreased morbidity, shorter convalescence, and the ability to avert the higher risk of extirpative surgery in an aging patient population.