Long-term oncologic outcomes following radiofrequency ablation with real-time temperature monitoring for T1a renal cell cancer

Gideon Lorber, Michael Glamore, Mehul Doshi, Merce Jorda, Gaston Morillo-Burgos, Raymond J. Leveillee

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

Objective: Few studies report long-term follow-up of renal cancer treated by radiofrequency ablation (RFA), thus limiting the comparison of this modality to well-established long-term follow-up series of surgically resected renal masses. Herein, we report long-term oncologic outcomes of renal cancer treated with RFA in a single institution. Methods and materials: We retrospectively reviewed patients treated between November 2001 and October 2012 with laparoscopic-guided or computed tomography-guided RFA. All treatments were performed with real-time thermometry ensuring target ablation temperature (>60°C) was adequately reached. Only patients with biopsy-confirmed T1a-category cancer and a follow-up period>48 months were included in our analysis. Follow-up included office visits, laboratory work, and periodic contrast-enhanced imaging. Survival was calculated using the Kaplan-Meier analysis. Overall complications were reported using the Clavien-Dindo scale. Results: Of 434 RFA cases, 53 treatments in 50 patients met the inclusion criteria. Of these, 29 were treated with computed tomography-guided RFA and 24 with laparoscopic-guided RFA. The mean follow-up interval was 65.6 months (48.5-120.2), and the mean renal mass size was 2.3. cm (0.3-4.0). There were 4 (7.5%) local recurrences and 1 case of distant metastases with no local recurrence. The 5-year overall survival was 98%, cancer-specific survival was 100%, and recurrence-free survival was 92.5%. The complication rate was 26.4%, which included 71% of Clavien-Dindo grade I and 29% of grade II. Mean estimated glomerular filtration rate preoperatively and at the most recent follow-up visit was 77 and 66. ml/min, respectively. Conclusions: When performed on selected patients, while monitoring real-time temperatures to ensure adequate treatment end points, RFA offers favorable long-term oncologic outcomes approaching those reported for partial nephrectomy.

Original languageEnglish (US)
Pages (from-to)1017-1023
Number of pages7
JournalUrologic Oncology: Seminars and Original Investigations
Volume32
Issue number7
DOIs
StatePublished - Oct 1 2014

Keywords

  • Image-guided therapy
  • Laparoscopy
  • Malignant disease
  • Percutaneous renal surgery
  • Renal cancer
  • Thermal ablation

ASJC Scopus subject areas

  • Oncology
  • Urology

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