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Advancing Treatment Frontiers: Radiofrequency Ablation for Small Renal Mass-Intermediate-Term Results
Rohit Kumar Singh1, Manav Gideon2, Rohan Rajendran1
1Department of Urology, Amrita Institute of Medical Sciences, Kochi, India.
Abstract:
Our study aims to discern the immediate and intermediate-term oncological outcomes of the patients with small renal mass and who were surgically unfit or were having a bilateral tumor and underwent radiofrequency ablation (RFA) of the mass. We retrospectively and prospectively analyzed the status of the patients who were diagnosed to have small renal masses and were biopsy-proven renal cell carcinoma (RCC) cases, who underwent RFA at our institute from the year 2013 to 2022. Patients were followed-up for 3 years. Data regarding complications were analyzed for all patients who underwent renal RFA along with the 3-year recurrence-free survival (RFS) rate. A total of 28 patients were eligible for the study based on our inclusion and exclusion criteria. Their renal function was recorded. They underwent RFA and were followed-up for a period of 3 years for RFS. Four patients out of the total had immediate complications, out of which two developed a hematoma. Three-year-follow-ups showed six recurrences, overall having 78.6% RFS. Post-procedural renal function was stable as documented by Estimated glomerular filtration rate. Oncological results of RFA in patients with small renal masses who are surgically unfit are associated with a low risk of immediate and intermediate-term deterioration of renal function.
Insights
Radiofrequency ablation (RFA) offers a viable treatment for small renal masses in surgically unfit patients. This study shows RFA has acceptable oncological outcomes and preserves renal function over three years.
Area of Science:
- Urology
- Oncology
- Nephrology
Background:
- Small renal masses (SRMs) pose treatment challenges, especially in patients unfit for surgery.
- Radiofrequency ablation (RFA) is an alternative minimally invasive treatment option.
Purpose of the Study:
- To evaluate the oncological outcomes and complications of RFA for SRMs.
- To assess the intermediate-term (3-year) recurrence-free survival (RFS) after RFA.
- To determine the impact of RFA on renal function in this patient cohort.
Main Methods:
- Retrospective and prospective analysis of 28 patients with biopsy-proven renal cell carcinoma (RCC) treated with RFA (2013-2022).
- Evaluation of immediate complications and 3-year RFS rates.
- Monitoring of renal function using Estimated Glomerular Filtration Rate (eGFR).
Main Results:
- Six recurrences were observed, resulting in a 3-year RFS of 78.6%.
- Four patients experienced immediate complications, including two cases of hematoma.
- Post-procedural renal function remained stable, with no significant deterioration in eGFR.
Conclusions:
- RFA is associated with a low risk of immediate and intermediate-term renal function decline in patients with SRMs.
- RFA demonstrates acceptable oncological control for SRMs in surgically unfit individuals.
- The 3-year recurrence-free survival rate suggests RFA is a feasible option for selected patients.
