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Radiofrequency ablation of small renal masses in comorbid patients

Jerzy Siekiera1, Milosz Jasinski1, Witold Mikołajczak2

  • 1Department of Oncological Urology, Oncology Centre, Bydgoszcz, Poland.

Wideochirurgia I Inne Techniki Maloinwazyjne = Videosurgery and Other Miniinvasive Techniques
|July 14, 2018
PubMed
Abstract

Insights

Radiofrequency ablation (RFA) offers a minimally invasive treatment option for small renal masses (SRMs) in high-risk patients. This study shows RFA is a safe and effective approach with excellent survival rates and minimal complications.

Area of Science:

  • Urology
  • Oncology
  • Minimally Invasive Surgery

Background:

  • Increasing detection of small renal masses (SRMs) due to advanced imaging.
  • Partial nephrectomy (NSS) is standard for T1a tumors but has limitations for high-risk patients.
  • Radiofrequency ablation (RFA) presents a minimally invasive alternative for patients unsuitable for surgery.

Purpose of the Study:

  • To evaluate the experience with radiofrequency ablation (RFA) for treating small renal masses (SRMs) in comorbid patients.
  • To assess the safety and efficacy of RFA in a high-risk surgical population.

Main Methods:

  • 103 percutaneous, ultrasound-guided RFA procedures were performed between 2006-2012.
  • Patients had an American Society of Anesthesiologists (ASA) score ≥ 3.
  • Procedures included pre-procedural CT scans and tumor biopsies, with an average follow-up of 46 months.

Main Results:

  • 1, 3, and 5-year overall survival rates were 97%, 90%, and 75%, respectively.
  • Cancer-specific survival was 100%.
  • No major complications (Clavien-Dindo grade ≥ 3) were observed.

Conclusions:

  • Percutaneous RFA is a safe and effective minimally invasive treatment for SRMs in comorbid patients.
  • RFA is a viable option for patients who are poor surgical candidates due to comorbidities.
  • The oncological effectiveness of RFA justifies its use in comorbid patients where other mortality causes are significant.
Keywords:
comorbiditiesradiofrequency ablationsmall renal masses

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