Radiofrequency Ablation Effective for Small, Early Stage Renal Tumors

By Will Boggs, MD

NEW YORK AUG 16, 2007 (Reuters Health) - Radiofrequency ablation is a reasonable alternative to partial nephrectomy for the treatment of T1a renal tumors, according to findings published in the August issue of BJU International.

"The techniques available to treat patients with small, incidentally discovered renal tumors (the majority of cases) are evolving rapidly and becoming less invasive and less morbid," Dr. Jeffrey A. Cadeddu told Reuters Health.

Dr. Cadeddu from the University of Texas, Southwestern Medical Center, Dallas, and colleagues reviewed their experience with clinical stage T1a renal tumors treated with either partial nephrectomy (37 patients) or in situ RF ablation (40 patients).

There were 3 treatment failures in the RF ablation group, the authors report, including 1 incomplete ablation and 2 local recurrences without distant metastases. There were 2 recurrences in the partial nephrectomy group.

The kidney preservation rate was 97.5% with RF ablation.

The 3-year recurrence-free survival was similar for with RF ablation (93.4%) and partial nephrectomy (95.8%), the authors report, and there were no disease-specific deaths in either group.

"The ideal patient for a laparoscopic RF ablation and partial nephrectomy is a patient who is, first a candidate for surgical resection, and second, the tumor is in the periphery of the kidney," Dr. Cadeddu explained. "For percutaneous RF ablation alone, the candidate is any patient with a posterior or lateral tumor of the kidney" -- because of need to have direct access to the tumor, and to avoid injury to other organs.

"To investigate the long term effectiveness of this technique, we need to continue to follow these patients closely," Dr. Cadeddu added. "They are the pioneers; their outcomes in the next 3 to 5 years will determine the technique"s acceptability."

SOURCE:

• BJU Int 2007;100:287-290.