Abstract
The objective of this study was to retrospectively evaluate the results of radiofrequency ablation (RFA) of renal tumors with an impedance-based system using an expandable multitined electrode. Twenty-two patients (30 tumors) were treated with RFA over a 7-year period, percutaneously (16 tumors) or intraoperatively (14 tumors). Follow-up imaging was performed at 1–3, 6, and 12 months and yearly thereafter. Twenty-seven of 30 tumors (19/22 patients) showed no residual tumor on the first imaging control. Two residual tumors were successfully ablated by a second RFA procedure. Our mean follow-up period was 35 months (range, 3–84 months). Two tumors that had been completely ablated based on imaging criteria recurred 11 and 48 months after RFA. One was treated by partial nephrectomy. The other one was not treated because the patient developed bone metastases. One patient had nephrectomy because of an RFA-induced ureteropelvic junction stricture. Nine patients (11 sessions) had a pyeloperfusion of cooled saline during RFA. None developed symptomatic complications, even though in three patients the ablation zone extended to the closest calyx (3–5 mm from the tumor). We conclude that RFA of renal tumors is promising, but serious complications to the collecting system must be taken into consideration. Prophylactic per-procedural cooling of the collecting system is feasible but needs further assessment.
Similar content being viewed by others
References
Gervais DA, McGovern FJ, Arellano RS et al (2005) Radiofrequency ablation of renal cell carcinoma: part 1, Indications, results, and role in patient management over a 6-year period and ablation of 100 tumors. AJR 185:64–71
Gervais DA, Arellano RS, McGovern FJ et al (2005) Radiofrequency ablation of renal cell carcinoma: part 2. Lessons learned with ablation of 100 tumors. AJR 185:72–80
Farrell MA, Charboneau WJ, DiMarco DS et al (2003) Imaging-guided radiofrequency ablation of solid renal tumors. AJR 180:1509–1513
Mayo-Smith WW, Dupuy DE, Parikh PM et al (2003) Imaging-guided percutaneous radiofrequency ablation of solid renal masses: techniques and outcomes of 38 treatment sessions in 32 consecutive patients. AJR 180:1503–1508
Veltri A, Calvo A, Tosetti I et al (2006) Experiences in US-guided percutaneous radiofrequency ablation of 44 renal tumors in 31 patients: analysis of predictors for complications and technical success. CardioVasc Interv Radiol 29:811–818
Zagoria RJ, Hawkins AD, Clark PE et al (2004) Percutaneous CT-guided radiofrequency ablation of renal neoplasms: factors influencing success. AJR 183:201–207
Matsumoto ED, Johnson DB, Ogan K et al (2005) Short-term efficacy of temperature-based radiofrequency ablation of small renal tumors. Urology 65:877–881
Varkarakis IM, Allaf ME, Inagaki T et al (2005) Percutaneous radio frequency ablation of renal masses: results at a 2-year mean followup. J Urol 174:456–460, discussion 460
Ahrar K, Matin S, Wood CG et al (2005) Percutaneous radiofrequency ablation of renal tumors: technique, complications, and outcomes. J Vasc Interv Radiol 16:679–688
Weizer AZ, Raj GV, O’Connell M et al (2005) Complications after percutaneous radiofrequency ablation of renal tumors. Urology 66:1176–1180
Sabharwal R, Vladica P (2006) Renal tumors: technical success and early clinical experience with radiofrequency ablation of 18 tumors. CardioVasc Interv Radiol 29:202–209
Arzola J, Baughman SM, Hernandez J et al (2006) Computed tomography-guided, resistance-based, percutaneous radiofrequency ablation of renal malignancies under conscious sedation at two years of follow-up. Urology 68:983–987
Clark TW, Malkowicz B, Stavropoulos SW et al (2006) Radiofrequency ablation of small renal cell carcinomas using multitined expandable electrodes: preliminary experience. J Vasc Interv Radiol 17:513–519
Memarsadeghi M, Schmook T, Remzi M et al (2006) Percutaneous radiofrequency ablation of renal tumors: midterm results in 16 patients. Eur J Radiol 59:183–189
Breen DJ, Rutherford EE, Stedman B et al (2007) Management of renal tumors by image-guided radiofrequency ablation: experience in 105 tumors. CardioVasc Interv Radiol 30:936–942
Gebauer B, Werk M, Lopez-Hanninen E et al (2007) Radiofrequency ablation in combination with embolization in metachronous recurrent renal cancer in solitary kidney after contralateral tumor nephrectomy. CardioVasc Interv Radiol 30:644–649
Zelkovic PF, Resnick MI (2003) Renal radiofrequency ablation: clinical status 2003. Curr Opin Urol 13:199–202
Desai MM, Gill IS (2002) Current status of cryoablation and radiofrequency ablation in the management of renal tumors. Curr Opin Urol 12:387–393
Hacker A, Vallo S, Weiss C et al (2005) Minimally invasive treatment of renal cell carcinoma: comparison of 4 different monopolar radiofrequency devices. Eur Urol 48:584–592
Rehman J, Landman J, Lee D et al (2004) Needle-based ablation of renal parenchyma using microwave, cryoablation, impedance- and temperature-based monopolar and bipolar radiofrequency, and liquid and gel chemoablation: laboratory studies and review of the literature. J Endourol 18:83–104
Johnson DB, Solomon SB, Su LM et al (2004) Defining the complications of cryoablation and radio frequency ablation of small renal tumors: a multi-institutional review. J Urol 172:874–877
Wah TM, Irving HC (2007) Acute tubular necrosis following radiofrequency ablation of a renal cell carcinoma. CardioVasc Interv Radiol (in press)
Johnson DB, Saboorian MH, Duchene DA et al (2003) Nephrectomy after radiofrequency ablation-induced ureteropelvic junction obstruction: potential complication and long-term assessment of ablation adequacy. Urology 62:351–352
Hwang JJ, Walther MM, Pautler SE et al (2004) Radio frequency ablation of small renal tumors: intermediate results. J Urol 171:1814–1818
Uribe PS, Costabile RA, Peterson AC (2006) Progression of renal tumors after laparoscopic radiofrequency ablation. Urology 68:968–971
Rendon RA, Kachura JR, Sweet JM et al (2002) The uncertainty of radio frequency treatment of renal cell carcinoma: findings at immediate and delayed nephrectomy. J Urol 167:1587–1592
Rehman J, Landman J, Sundaram CP (2002) Re: The uncertainty of radio frequency treatment of renal cell carcinoma: findings at immediate and delayed nephrectomy. J Urol 168:2128–2129, author reply 2129–2130
Gill IS, Hsu TH, Fox RL et al (2000) Laparoscopic and percutaneous radiofrequency ablation of the kidney: acute and chronic porcine study. Urology 56:197–200
Crowley JD, Shelton J, Iverson AJ et al (2001) Laparoscopic and computed tomography-guided percutaneous radiofrequency ablation of renal tissue: acute and chronic effects in an animal model. Urology 57:976–980
Hsu TH, Fidler ME, Gill IS (2000) Radiofrequency ablation of the kidney: acute and chronic histology in porcine model. Urology 56:872–875
Gulesserian T, Mahnken AH, Schernthaner R et al (2006) Comparison of expandable electrodes in percutaneous radiofrequency ablation of renal cell carcinoma. Eur J Radiol 59:133–139
Dechet CB, Zincke H, Sebo TJ et al (2003) Prospective analysis of computerized tomography and needle biopsy with permanent sectioning to determine the nature of solid renal masses in adults. J Urol 169:71–74
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rouvière, O., Badet, L., Murat, F.J. et al. Radiofrequency Ablation of Renal Tumors with an Expandable Multitined Electrode: Results, Complications, and Pilot Evaluation of Cooled Pyeloperfusion for Collecting System Protection. Cardiovasc Intervent Radiol 31, 595–603 (2008). https://doi.org/10.1007/s00270-007-9291-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00270-007-9291-3