Ces radiol. 2011, 65(2):124-130

Percutaneous radiofrequency ablation of the renal tumors - five years experience with minimally invasive therapyOriginal article

Petr Hoffmann¹, Petr Dvořák¹, Pavel Navrátil², Petr Moravek², Hynek Šafránek², Petra Cibereová³, Jan Raupach¹

¹ Radiologická klinika LF UK a FN, Hradec Králové

² Urologická klinika LF UK a FN, Hradec Králové

³ Klinika anesteziologie, resuscitace a intenzívní medicíny LF UK a FN, Hradec Králové

Aim: To evaluate our mid term radiological, technical and interventional features and experience with computed tomography-guided percutaneous radiofrequency ablation of the renal tumors using StarBurst instruments with selfexpandable electrods.

Method: The group of 44 patients with mean age 73,24 ± 7,78 years underwent during a period of 60 months CT-guided RFA treatments for enhancing renal masses, with a mean size 29,39 ± 12,83 mm, using only conscious sedation and local anesthesia. All patients had multiple medical comorbidities that limited or completely contraindicated surgical treatment. In eight cases tumors involved solitary kidneys. Patients were hospitalized in anesthesiologic and then urologic department of University hospital, where possible early complications were monitored. Patients were followed with clinical status and renal function studies. Also contrast medium-enhanced imaging examinations (enhanced computed tomography in 35 patients and magnetic resonance in eight patients) were performed 1 month, 3 to 6, 12 and 24 months and then with a one year period after initial procedure. Successful ablation was defined as a lack of enhancement of the renal mass eventually with a scar-like retraction of surrounding renal parenchyma.

Results: During a 60-months period (from February 2006 to February 2011) 65 percutaneous CT-guided RFA treatments in 44 patients for 48 renal tumors were performed. In 33 tumors (70%) were single treatment successful, in 10 cases (21%) we used second procedure successfully and in 4 largest tumors (9%) also third RFA treatment for complete destruction of the neoplasm was necessary. One patient died two months after the procedure because of chronic congestive heart failure and pulmonary diseases and the success of the treatment stayed unknown. In four cases with parallel renal tumor and disseminated lung cancer was ablation performed as a palliative treatment. Patients stayed in hospital for 2 days. We revealed two complications - retroperitoneal hematomas, which resolved spontaneously and needed no interventional treatment. Length of the following-up was from 2 to 60 months.

Conclusion: CT-guided percutaneous radiofrequency ablation is a therapeutic alternative of surgical methods (nephrectomies or nephron-sparing surgical devices) especially with smaller renal tumors in patients with multiple medical comorbidities and tumors in solitary kidneys and shows satisfactory mid term results.

Keywords: percutaneous radiofrequency ablation, renal tumors, minimally invasive therapy

Accepted: March 31, 2011; Published: June 1, 2011  Show citation