La radiologia medica

, Volume 117, Issue 4, pp 606–615 | Cite as

Radiofrequency ablation of renal cell carcinoma in patients with a solitary kidney: a retrospective analysis of our experience

  • R. F. Grasso
  • G. Luppi
  • E. Faiella
  • F. Giurazza
  • R. Del Vescovo
  • R. L. Cazzato
  • B. Beomonte Zobel
Urogenital Radiology / Radiologia URO-Genitale
First Online:
Received:
Accepted:
  • 142 Downloads

Abstract

Purpose

This study was done to evaluate the feasibility and safety of radiofrequency ablation (RFA) of renal cell carcinomas (RCCs) in patients with solitary kidney.

Materials and methods

Seven patients (two men, five women; age range 52–70 years; mean age 59.7 years) were treated under computed tomography (CT) and ultrasound (US) guidance. Three patients had single lesions, and the remaining four had multiple lesions. Seventeen lesions (4 cortical, 13 exophytic, maximum diameter range 12–40 mm, mean 21.0 mm) not located close to the renal pelvis were treated. CT or magnetic resonance (MR) imaging follow-up studies were obtained for all patients at the end of the procedure and at 1, 3, 6 and 12 months; serum creatinine was also monitored.

Results

Ten ablation sessions were performed. In two patients, a perinephric haematoma was detected, and one of these patients had two episodes of self-limiting haematuria. Contrast-enhanced CT and MR imaging at the end of the procedure and at 1 month demonstrated 100% technical success; these results were confirmed at 3, 6 and 12 month. Fisher’s test comparing serum creatinine obtained 1 day before and 1 day after the procedure showed no case of acute renal failure (mean serum creatinine 24 h before the procedure 1.02 mg/dl; mean serum creatinine 24 h after the procedure 0.95 mg/dl; p=0.114; not significant). Serum creatinine at follow-up was always within the normal range.

Conclusions

Radiofrequency ablation in the solitary kidney is a safe and effective procedure for treating RCC.

Keywords

Radiofrequency ablation Renal cell carcinoma Solitary kidney US guidance CT guidance 

Ablazione mediante radiofrequenze di adenocarcinomi renali in pazienti con rene solitario: analisi retrospettiva della nostra esperienza

Riassunto

Obiettivo

Scopo del nostro lavoro è stato valutare l’efficacia e la sicurezza dell’ablazione a radiofrequenza (RFA) del carcinoma renale (RCC) in pazienti con rene solitario.

Materiali e metodi

Sette pazienti (2 uomini e 5 donne; età compresa tra 52 e 70 anni; età media 59,7 anni) sono stati trattati sotto guida tomografica computerizzata (TC) ed ecografica. Tre pazienti avevano una lesione singola; i restanti quattro presentavano multiple localizzazioni. Complessivamente diciassette lesioni (4 corticali e 13 esofitiche, con diametro massimo compreso tra 12 e 40 mm, in media 21 mm) non adiacenti alla pelvi renale sono state trattate. TC e risonanza magnetica (RM) sono state le metodiche scelte per il follow-up al termine di ogni procedura e a distanza di 1, 3, 6 e 12 mesi; sono stati monitorati anche i valori di creatinina sierica.

Risultati

In totale sono state condotte 10 sedute ablative. In 2 pazienti abbiamo riscontrato la presenza di un ematoma peri-renale ed in uno di questi due pazienti sono stati riportati anche 2 episodi di ematuria, regrediti spontaneamente. Il successo tecnico, raggiunto nel 100% dei casi, è stato dimostrato grazie al controllo mediante TC o RM con somministrazione di agente di contrasto al termine di ogni procedura e a distanza di un mese; i follow-up a 3, 6 e 12 mesi hanno confermato questo dato. Nessun caso di insufficienza renale acuta è stato riscontrato dopo aver applicato il test di Fisher comparando i valori di creatinina sierica misurati il giorno prima e il giorno dopo la procedura, (valore medio di creatinina sierica 24 ore prima della procedura: 1,02 mg/dl; valore medio di creatinina sierica il giorno dopo: 0,95 mg/dl; p=0,114, non significativo). I valori di creatinina sierica nei successivi controlli a distanza sono sempre stati nei limiti della norma.

Conclusioni

La RFA si è rivelata una procedura sicura ed efficace nel trattamento dei carcinomi a cellule renali nei pazienti con rene solitario.

Parole chiave

Ablazione a radiofrequenza Carcinoma renale Rene solitario Guida ecografia Guida TC 
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Copyright information

© Springer-Verlag Italia 2011

Authors and Affiliations

  • R. F. Grasso
    • 1
  • G. Luppi
    • 1
  • E. Faiella
    • 1
  • F. Giurazza
    • 1
  • R. Del Vescovo
    • 1
  • R. L. Cazzato
    • 1
  • B. Beomonte Zobel
    • 1
  1. 1.Dipartimento di Diagnostica per ImmaginiUniversità “Campus Bio-Medico” di RomaRomaItaly

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