CT-guided RFA Using a Urine-Hyperexcreting Protocol in Treating Endophytic RCC: Long-term Outcomes in a Single-Arm...

Area of Science:

• Urology
• Oncology
• Nephrology

Background:

• Endophytic renal cell carcinomas (RCCs) present unique treatment challenges.
• Percutaneous radiofrequency ablation (RFA) is a minimally invasive option for RCC.
• The impact of urine-hyperexcreting protocols on RFA outcomes for endophytic RCCs requires evaluation.

Purpose of the Study:

• To assess the oncologic and functional long-term outcomes of endophytic RCCs treated with CT-guided RFA.
• To evaluate the influence of a urine-hyperexcreting protocol during RFA on patient outcomes.
• To determine the safety and efficacy of this specific RFA approach.

Main Methods:

• Retrospective analysis of 61 patients with histologically proven endophytic RCC treated with CT-guided RFA.
• Inclusion of a urine-hyperexcreting protocol involving furosemide injection and saline infusion.
• Assessment of 5-year local tumor progression (LTP)-free survival, changes in estimated glomerular filtration rate (eGFR), and complication rates.

Main Results:

• A 5-year LTP-free survival rate of 96.7% was achieved.
• A statistically significant decrease in mean eGFR was observed post-RFA (p < 0.001).
• A major complication rate of 1.6% (uretero-pelvic stricture) was reported, with no significant eGFR decline in patients with baseline eGFR ≥90.

Conclusions:

• CT-guided RFA utilizing a urine-hyperexcreting protocol demonstrates favorable oncologic outcomes for endophytic RCCs.
• The protocol provides acceptable long-term functional results, particularly in patients with normal renal function.
• Further research is warranted to compare this protocol with non-diuretic or pyeloperfusion methods.