Skip to main content
SpringerLink
Log in

Radiofrequency ablation (RFA) of T1a renal cancer with externally cooled multitined expandable electrodes

  • URO-GENITAL RADIOLOGY
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Introduction

To retrospectively evaluate the mid-term outcomes of percutaneous radiofrequency ablation (RFA) with multitined expandable electrodes externally cooled with saline solution in patients with T1a renal cell carcinoma (RCC).

Materials and methods

In this retrospective study, we evaluated 39 RCC in 35 patients treated with CT-guided RFA in 41 procedures (2011–2017). All patients were staged T1a, N0, M0 prior to RFA. Mean tumor size was 24.48 mm. A 4-tined expandable RFA electrode cooled with pump-circulating saline was used. Efficacy was evaluated verifying complete tumor necrosis (no contrast enhancement on imaging) at the end of the procedure and on subsequent controls. Follow-up observation period was 5 years. Minor/major complications, hospitalization days, serum creatinine and GFR pre- and post-RFA (compared using paired t test) and post-operative pain (evaluated with NRS after treatment) were considered as safety indicators. Overall survival was also calculated (Kaplan–Meier method).

Results

Of 35 patients, 30/35 had 1 treatment (primary effectiveness rate 86%), 4/35 had 2 treatments and 1/35 had 3 treatments for residual disease. There were no relapses and no mid-long-term complications; 3 minor (8%) and 1 major (2.7%) complications during perioperative period were reported. Mean before and after RFA serum creatinine rates were, respectively, 1.08 mg/dl and 1.11 mg/dl (p value: 0.4117). NRS median value is 0.8. Hospitalization days median value is [2.8 ± 1.9] days. 91.4% of all patients survived, with a median overall survival time of 65 months.

Conclusions

Mid-term results show that CT-guided RFA with multitined expandable electrodes externally cooled with saline solution is an effective and safe treatment in patients with RCC-staged T1aN0M0. Data reported in our study are in line with data reported in the literature from patients treated with other devices.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Guidelines For Renal Tumors (2016) AIOM (Italian Association of Medical Oncology)

  2. Ridge CA, Pua BB, Madoff DC (2014) Epidemiology and staging of renal carcinoma. Semin Interv Radiol 31:3–8. https://doi.org/10.1055/s-0033-1363837

    Article  Google Scholar 

  3. Ng CS, Wood CG, Silverman PM et al (2008) Renal cell carcinoma: diagnosis, staging, and surveillance. AJR Am J Roentgenol 191:1220–1232. https://doi.org/10.2214/AJR.07.3568

    Article  PubMed  Google Scholar 

  4. Gervais DA, McGovern FJ, Arellano RS et al (2005) Radiofrequency ablation of renal cell carcinoma. Indications, results, and role in patient management over a 6-year period and ablation of 100 tumors. AJR Am J Roentgenol 185:64–71

    Article  Google Scholar 

  5. Zagoria RJ, Hawkins AD, Clark PE et al (2004) Percutaneous CT-guided radiofrequency ablation of renal neoplasms: factors influencing success. AJR Am J Roentgenol 183:201–207. https://doi.org/10.2214/ajr.183.1.1830201

    Article  PubMed  Google Scholar 

  6. Chow WH, Devesa SS, Warren JL, Fraumeni JF Jr (1999) Rising incidence of renal cell cancer in the United States. JAMA 281:1628–1631

    Article  CAS  Google Scholar 

  7. Lee JH, You CH, Min GE et al (2007) Comparison of the surgical outcome and functional outcome between radical and nephron-sparing surgery for renal cell carcinoma. Korean J Urol 48:671–676. https://doi.org/10.4111/kju.2007.48.7.671

    Article  Google Scholar 

  8. Van Poppel H, Da Pozzo L, Albrecht W et al (2011) A prospective, randomized EORTC phase 3 study comparing the oncologic out come of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol 59:543–552. https://doi.org/10.1016/j.eururo.2010.12.013

    Article  PubMed  Google Scholar 

  9. Fergany AF, Hafez KS, Novick AC (2000) Long-term results of nephron-sparing surgery for localized renal cell carcinoma: 10-year follow up. J Urol 163:442–445

    Article  CAS  Google Scholar 

  10. Uzzo RG, Novick AC (2001) Nephron-sparing surgery for renal tumors: indications, techniques and outcomes. J Urol 166:6–18

    Article  CAS  Google Scholar 

  11. Zagoria RJ (2004) Imaging-guided radiofrequency ablation of renal masses. Radiographics 24(Suppl 1):S59–S71

    Article  Google Scholar 

  12. Kawamoto S, Solomon SB, Bluemke DA et al (2009) CT and MR imaging appearance of renal neoplasms after radiofrequency ablation and cryoablation. Semin Ultrasound CT MR 30:67–77

    Article  Google Scholar 

  13. Farrell MA, Charboneau WJ, DiMarco DS et al (2003) Imaging-guided radiofrequency ablation of solid renal tumors. AJR Am J Roentgenol 180:1509–1513

    Article  CAS  Google Scholar 

  14. Gervais DA, McGovern FJ, Wood BJ et al (2000) Radio-frequency ablation of renal cell carcinoma: early clinical experience. Radiology 217:665–672

    Article  CAS  Google Scholar 

  15. Spreafico C, Nicolai N, Lanocita R et al (2012) CT-guided percutaneous cryoablation of renal masses in selected patients. Radiol Med 117(4):593–605. https://doi.org/10.1007/s11547-011-0742-1

    Article  CAS  PubMed  Google Scholar 

  16. Goldberg SN, Gazelle GS, Compton CC et al (2000) Treatment of intrahepatic malignancy with radiofrequency ablation: radiologic-pathologic correlation. Cancer 88:2452–2463

    Article  CAS  Google Scholar 

  17. Russo U, Maestroni U, Papapietro RV et al (2018) Imaging after radiofrequency ablation of renal tumors. Future Oncol 14:2915–2922

    Article  CAS  Google Scholar 

  18. Cardella JF, Kundu S, Miller DL et al (2009) Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol 20(7 Suppl):S189–S191

    Article  Google Scholar 

  19. Ferlay J, Steliarova-Foucher E, Lortet-Tieulant J et al (2013) Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer 49:1374–1403

    Article  CAS  Google Scholar 

  20. Tsui KH, Shvarts O, Smith RB et al (2000) Renal cell carcinoma: prognostical significance of incidentally detected tumors. J Urol 163:426–430

    Article  CAS  Google Scholar 

  21. Patard JJ, Rodriguez A, Rioux-Leclercq N et al (2002) Prognostic significance of the mode of detection in renal tumors. BJU Int 90:358–363

    Article  Google Scholar 

  22. Herr HW (1999) Partial nephrectomy for unilateral renal carcinoma and a normal contralateral kidney: 10-year follow-up. J Urol 161:33–35

    Article  CAS  Google Scholar 

  23. Gill IS, Kavoussi LR, Lane BR et al (2007) Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol 178:41–46

    Article  Google Scholar 

  24. Park H, Byun SS, Kim HH et al (2010) Comparison of laparoscopic and open partial nephrectomies in T1a renal cell carcinoma: a Korean multi center experience. Korean J Urol 51:467–471

    Article  Google Scholar 

  25. Zlotta AR, Wildschutz T, Raviv G et al (2007) Radiofrequency interstitial tumor ablation (RITA) is a possible new modality for treatment of renal cancer: ex vivo and in vivo experience. J Endourol 11:251–258

    Article  Google Scholar 

  26. Campbell SC, Novick AC, Belldegrun A et al (2009) Guidelines for management of the clinical T1 renal mass. J Urol 182:1271–1279

    Article  Google Scholar 

  27. Ljunberg B, Bensalah K, Canfield S et al (2015) EAU Guidelines on renal cell carcinoma: 2014 updates. Eur Urol 67:913–924

    Article  Google Scholar 

  28. Clark TW, Millward SF, Gervais DA et al (2009) Reporting standards for percutaneous thermal ablation of renal cell carcinoma. J Vasc Interv Radiol 20(7 Suppl):S409–S416

    Article  Google Scholar 

  29. Van Poppel H, Becker F, Cadeddu JA et al (2011) Treatment of localised renal cell carcinoma. Eur Urol 60:662–672

    Article  Google Scholar 

  30. Young EE, Castle SM, Gorbatiy V et al (2012) Comparison of safety, renal function outcomes and efficacy of laparoscopic and percutaneous radiofrequency ablation of renal masses. J Urol 187:1177–1182

    Article  Google Scholar 

  31. Lian H, Guo H, Zhang G et al (2012) Single center comparison of complication in laparoscopic and percutaneous radiofrequency ablation with ultrasound guidance for renal tumors. Urol 80:119–124

    Article  Google Scholar 

  32. Trudeau V, Larcher A, Boehm K et al (2016) Comparison of post-operative complications and mortality between laparoscopic and percutaneous local tumor ablation for T1a renal cell carcinoma: a population-based study. Urology 89:63–68

    Article  Google Scholar 

  33. Takaki H, Yamakado K, Soda N et al (2010) Midterm results of radiofrequency ablation versus nephrectomy for T1a renal cell carcinoma. Jpn J Radiol 28:460–468

    Article  Google Scholar 

  34. Varkarakis IM, Allaf ME, Inagaki T et al (2005) Percutaneous radiofrequency ablation of renal masses: results at a 2-year mean follow up. JURO 174:456–460

    Google Scholar 

  35. Clark TWI, Malkowicx 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

    Article  Google Scholar 

  36. Breen DJ, Rutheford EE, Stedman B et al (2007) Management of renal tumors by image-guided radiofrequency ablation: experience in 105 tumors. Cardiovasc Intervent Radiol 30:936–942

    Article  Google Scholar 

  37. Curry D, Pahujia A, Loan W et al (2018) Radiofrequency ablation of small renal masses: outcome, complications, and effects on renal functions. Curr Urol 11:196–200

    Article  Google Scholar 

  38. Ito K, Soga S, Seguchi K et al (2017) Clinical outcomes of percutaneous radiofrequency ablation for small renal cancer. Oncol Lett 14:918–924

    Article  Google Scholar 

  39. Zhou W, Arellano RS (2018) Thermal ablation of T1c renal cell carcinoma: a comparative assessment of technical performance, procedural outcome, and safety of microwave ablation, radiofrequency ablation, and cryoablation. J Vasc Interv Radiol 26:943–951

    Article  Google Scholar 

  40. Dai W, Covarrubias D, Uppot R et al (2017) Image-guided percutaneous radiofrequency ablation of central renal cell carcinoma: assessment of clinical efficacy and safety in 31 tumors. J Vasc Interv Radiol 28:1643–1650

    Article  Google Scholar 

  41. Wah TM, Irving HC, Gregory W et al (2014) Radiofrequency ablation (RFA) of renal cell carcinoma (RCC): experience in 200 tumours. BJU Int 113:416–428

    Article  Google Scholar 

  42. Johnson BA, Sorokin I, Cadeddu JA (2019) Ten-year outcomes of renal tumor radio frequency ablation. J Urol 201:251–258

    Article  Google Scholar 

  43. Filippiadis D, Mauri G, Marra P et al (2019) Percutaneous ablation techniques for renal cell carcinoma: current status and future trends. Int J Hyperthermia 36:21–30

    Article  CAS  Google Scholar 

  44. Floridi C, De Bernardi I, Fontana F et al (2014) Microwave ablation of renal tumors: state of the art and development trends. Radiol Med 119(7):533–540. https://doi.org/10.1007/s11547-014-0426-8

    Article  PubMed  Google Scholar 

  45. Chang X, Liu T, Zhang F et al (2015) Radiofrequency ablation versus partial nephrectomy for clinical T1a renal-cell carcinoma: long-term clinical and oncologic outcomes based on a propensity score analysis. J Endourol 29:518–525

    Article  Google Scholar 

  46. Olweny EO, Park SK, Tan YK et al (2012) Radiofrequency ablation versus partial nephrectomy in patients with solitary clinical T1a renal cell carcinoma: comparable oncologic outcomes at a minimum of 5 years of follow-up. Eur Urol 61:1156–1161

    Article  Google Scholar 

  47. Regier M, Chun F (2015) Thermal ablation of renal tumors: indications, techniques and results. Dtsch Arztebl Int 112:412–418

    PubMed  PubMed Central  Google Scholar 

  48. De Filippo M, Bozzetti F, Martora R et al (2014) Radiofrequency thermal ablation of renal tumors. Radiol Med 119:499–511. https://doi.org/10.1007/s11547-014-0412-1

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine and Surgery, Unit of Radiology, University of Parma, Via Gramsci 14, Parma, Italy

    Massimo De Filippo & Francesco Pagnini

  2. Department of Surgery, Unit of Urology, University-Hospital of Parma, Via Gramsci 14, Parma, Italy

    Francesco Ziglioli & Umberto Maestroni

  3. Department of Medicine and Surgery, Unit of Radiologic Sciences, University-Hospital of Parma, Via Gramsci 14, Parma, Italy

    Umberto Russo & Paolo Pagano

  4. Department of Medicine and Health Science, University of Molise, Via Francesco De Santis 86, Campobasso, Italy

    Luca Brunese

  5. Department of Radiology, University-Hospital of Careggi, Largo Brambilla 3, Florence, Italy

    Elena Bertelli

Authors
  1. Massimo De Filippo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Francesco Ziglioli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Umberto Russo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Paolo Pagano
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Luca Brunese
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Elena Bertelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Francesco Pagnini
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Umberto Maestroni
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Massimo De Filippo.

Ethics declarations

Conflict of interest

Each author declares that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangement, etc.) that might pose a conflict of interest in connection with the submitted article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

De Filippo, M., Ziglioli, F., Russo, U. et al. Radiofrequency ablation (RFA) of T1a renal cancer with externally cooled multitined expandable electrodes. Radiol med 125, 790–797 (2020). https://doi.org/10.1007/s11547-020-01175-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11547-020-01175-1

Keywords

Search

Navigation