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Contemporary Status of Percutaneous Ablation for the Small Renal Mass

  • Minimally Invasive Surgery (T Guzzo, Section Editor)
  • Published:
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Abstract

Renal cell carcinoma is the tenth most common malignancy in the USA, with upwards of 61,000 new cases and resulting in more than 14,000 deaths annually. Although partial nephrectomy remains the standard treatment, image-guided nephron-sparing ablative techniques including cryoablation, radiofrequency ablation, and microwave ablation have emerged as treatment options in certain patient populations. Ablative therapies have high technical successes, low tumor recurrence rates, and preserve renal parenchymal volume. The purpose of this article is to provide an update on ablation therapies for small renal masses.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Rini BI, Campbell SC, Escudier B. Renal cell carcinoma. Lancet. 2009;373(9669):1119–32. doi:S0140-6736(09)60229-4 [pii]10.1016/S0140-6736(09)60229-4

  2. Cohen HT, McGovern FJ. Renal-cell carcinoma. N Engl J Med. 2005;353(23)):2477. doi:10.1056/NEJMra043172.

    Article  CAS  PubMed  Google Scholar 

  3. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69. doi:10.3322/caac.20107.

    Article  PubMed  Google Scholar 

  4. Sahni VA, Silverman SG. Imaging management of incidentally detected small renal masses. Semin Intervent Radiol. 2014;31(1):9. doi:10.1055/s-0033-136383800813.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Finley DS, Pantuck AJ, Belldegrun AS. Tumor biology and prognostic factors in renal cell carcinoma. Oncologist. 2011;16(2):4. doi:10.1634/theoncologist.2011-S2-04.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Jonasch E, Gao J, Rathmell WK. Renal cell carcinoma. BMJ. 2014;349:g4797.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Bakal CW, Cynamon J, Lakritz PS, Sprayregen S. Value of preoperative renal artery embolization in reducing blood transfusion requirements during nephrectomy for renal cell carcinoma. J Vasc Interv Radiol. 1993;4(6):727.

    Article  CAS  PubMed  Google Scholar 

  8. Campbell SC, Novick AC, Belldegrun A, Blute ML, Chow GK, Derweesh IH. Guideline for management of the clinical T1 renal mass. J Urol. 2009;182((4):1271. doi:10.1016/j.juro.2009.07.004.

    Article  Google Scholar 

  9. Ljungberg B, Bensalah K, Canfield S, Dabestani S, Hofmann F, Hora M, et al. EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol. 2015;67(5):913. doi:10.1016/j.eururo.2015.01.005.

    Article  PubMed  Google Scholar 

  10. Van Poppel H, Becker F, Cadeddu JA, Gill IS, Janetschek G, Jewett MA, et al. Treatment of localised renal cell carcinoma. Eur Urol. 2011;60(4):662. doi:10.1016/j.eururo.2011.06.040.

    Article  PubMed  Google Scholar 

  11. Trudeau V, Larcher A, Boehm K, Dell'Oglio P, Sun M, Tian Z. Comparison of Postoperative Complications and Mortality Between Laparoscopic and Percutaneous Local Tumor Ablation for T1a Renal Cell Carcinoma: a Population-Based Study. Urology. 2015. doi:10.1016/j.urology.2015.08.043.

    PubMed  Google Scholar 

  12. Ogan K, Jacomides L, Dolmatch BL, Rivera FJ, Dellaria MF, Josephs SC, et al. Percutaneous radiofrequency ablation of renal tumors: technique, limitations, and morbidity. Urology. 2002;60(6):954.

    Article  PubMed  Google Scholar 

  13. Escudier B, Porta C, Schmidinger M, Algaba F, Patard JJ, Khoo V. Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25(3:ii):49. doi:10.1093/annonc/mdu259.

    Article  Google Scholar 

  14. Tuncali K, van Sonnenberg E, Shankar S, Mortele KJ, Cibas ES, Silverman SG. Evaluation of patients referred for percutaneous ablation of renal tumors: importance of a preprocedural diagnosis. AJR Am J Roentgenol. 2004;18(3):575. doi:10.2214/ajr.183.3.1830575. A study that highlights the importance of biopsy prior to ablation procedures.

    Article  Google Scholar 

  15. Schmit GD, Kurup AN, Weisbrod AJ, Thompson RH, Boorjian SA, Wass CT, et al. ABLATE: a renal ablation planning algorithm. AJR Am J Roentgenol. 2014;202(4):894. doi:10.2214/AJR.13.11110.

    Article  PubMed  Google Scholar 

  16. Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009;182(3):844. doi:10.1016/j.juro.2009.05.035.

    Article  PubMed  Google Scholar 

  17. Schmit GD, Thompson RH, Kurup AN, Weisbrod AJ, Boorjian SA, Carter RE. Usefulness of R.E.N.A.L. nephrometry scoring system for predicting outcomes and complications of percutaneous ablation of 751 renal tumors. J Urol. 2013;89(1):30. doi:10.1016/j.juro.2012.08.180. A study that introduces the RENAL nephrometry algorithm to predict the outcomes and complications associated with ablation procedures.

    Article  Google Scholar 

  18. Allen BC, Remer EM. Percutaneous cryoablation of renal tumors: patient selection, technique, and postprocedural imaging. Radiographics. 2010;30(4):887. doi:10.1148/rg.304095134.

    Article  PubMed  Google Scholar 

  19. Sahni VA, Silverman SG. Biopsy of renal masses: when and why. Cancer Imaging. 2009;9:44. doi:10.1102/1470-7330.2009.0005.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Ramanathan R, Leveillee RJ. Ablative therapies for renal tumors. Ther Adv Urol. 2010;2(2):51. doi:10.1177/175628721036670810.1177_1756287210366708.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Venkatesan AM, Wood BJ, Gervais DA. Percutaneous ablation in the kidney. . 2011;26(2):375. doi:10.1148/radiol.11091207.

    Google Scholar 

  22. Dominguez-Escrig JL, Sahadevan K, Johnson P. Cryoablation for small renal masses. Adv Urol. 2008:479495. doi:10.1155/2008/479495

  23. Zagoria RJ. Imaging-guided radiofrequency ablation of renal masses. Radiographics. 2004;24(1):S59. doi:10.1148/rg.24si045512.

    Article  PubMed  Google Scholar 

  24. Simon CJ, Dupuy DE, Mayo-Smith WW. Microwave ablation: principles and applications. Radiographics. 2005;25(1):S69. doi:10.1148/rg.25si055501.

    Article  PubMed  Google Scholar 

  25. Yu J, Liang P, Yu XL, Cheng ZG, Han ZY, Mu MJ. US-guided percutaneous microwave ablation of renal cell carcinoma: intermediate-term results. Radiology. 2012;263:900. doi:10.1148/radiol.12111209.

    Article  PubMed  Google Scholar 

  26. Weizer AZ, Raj GV, O'Connell M, Robertson CN, Nelson RC, Polascik TJ. Complications after percutaneous radiofrequency ablation of renal tumors. Urology. 2005;66(6):1176. doi:10.1016/j.urology.2005.06.125.

    Article  PubMed  Google Scholar 

  27. Kurup AN. Percutaneous ablation for small renal masses-complications. Semin Intervent Radiol. 2014;31(1):42. doi:10.1055/s-0033-136384200817.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Bhayani SB, Allaf ME, Su LM, Solomon SB. Neuromuscular complications after percutaneous radiofrequency ablation of renal tumors. Urology. 2005;65(3):592. doi:10.1016/j.urology.2004.09.053.

    Article  PubMed  Google Scholar 

  29. Higgins LJ, Hong K. Renal ablation techniques: state of the art. AJR Am J Roentgenol. 2015;205(4):735. doi:10.2214/AJR.15.14752.

    Article  PubMed  Google Scholar 

  30. Siu W, Hafez KS, 3rd Johnston WK, Jr. Wolf JS. Growth rates of renal cell carcinoma and oncocytoma under surveillance are similar. Urol Oncol. 2007;25(2):115. doi:10.1016/j.urolonc.2006.07.018.

    Article  PubMed  Google Scholar 

  31. Iannuccilli JD, Grand DJ, Dupuy DE, Mayo-Smith WW. Percutaneous ablation for small renal masses-imaging follow-up. Semin Intervent Radiol. 2014;31(1):50. doi:10.1055/s-0033-136384300818.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Stern JM, Svatek R, Park S, Hermann M, Lotan Y, Sagalowsky AI. Intermediate comparison of partial nephrectomy and radiofrequency ablation for clinical T1a renal tumours. BJU Int. 2007;100(2):287. doi:10.1111/j.1464-410X.2007.06937.x.

    Article  PubMed  Google Scholar 

  33. Olweny EO, Park SK, Tan YK, Best SL, Trimmer C, Cadeddu JA, et al. 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. 2012;61(6):1156. doi:10.1016/j.eururo.2012.01.001.

    Article  PubMed  Google Scholar 

  34. Chang X, Zhang F, Liu T, Ji C, Zhao X, Yang R. Radio frequency ablation versus partial nephrectomy for clinical T1b renal cell carcinoma: long-term clinical and oncologic outcomes. J Urol. 2015;193(2):430. doi:10.1016/j.juro.2014.07.112.

    Article  PubMed  Google Scholar 

  35. Thompson RH, Atwell T, Schmit G, Lohse CM, Kurup AN, Weisbrod A. Comparison of partial nephrectomy and percutaneous ablation for cT1 renal masses. Eur Urol. 2015;67(2):252–9. doi:10.1016/j.eururo.2014.07.021. A study comparing partial nephrectomy to both radiofrequency and cryoablation ablation for cT1 renal masses.

    Article  PubMed  Google Scholar 

  36. Klatte T, Grubmuller B, Waldert M, Weibl P, Remzi M. Laparoscopic cryoablation versus partial nephrectomy for the treatment of small renal masses: systematic review and cumulative analysis of observational studies. Eur Urol. 2011;60(3):435. doi:10.1016/j.eururo.2011.05.002.

    Article  PubMed  Google Scholar 

  37. Aron M, Kamoi K, Remer E, Berger A, Desai M, Gill I, et al. Laparoscopic renal cryoablation: 8-year, single surgeon outcomes. J Urol. 2010;183(3):889. doi:10.1016/j.juro.2009.11.041.

    Article  PubMed  Google Scholar 

  38. Zargar H, Samarasekera D, Khalifeh A, Remer EM, O'Malley C, Akca O. Laparoscopic vs percutaneous cryoablation for the small renal mass: 15-year experience at a single center. Urology. 2015;85(4):850. doi:10.1016/j.urology.2015.01.004. A study comparing laparoscopic and cryoablation for small renal masses showing no difference between overall or recurrence-free survival.

    Article  PubMed  Google Scholar 

  39. Goyal J, Verma P, Sidana A, Georgiades CS, Rodriguez R. Single-center comparative oncologic outcomes of surgical and percutaneous cryoablation for treatment of renal tumors. J Endourol. 2012;26(11):1413. doi:10.1089/end.2012.0244.

    Article  PubMed  Google Scholar 

  40. Moreland AJ, Ziemlewicz TJ, Best SL, Hinshaw JL, Lubner MG, Alexander ML, et al. High-powered microwave ablation of t1a renal cell carcinoma: safety and initial clinical evaluation. J Endourol. 2014;28(9):1046. doi:10.1089/end.2014.0190.

    Article  PubMed  Google Scholar 

  41. Yu J, Liang P, Yu XL, Cheng ZG, Han ZY, Zhang X. US-guided percutaneous microwave ablation versus open radical nephrectomy for small renal cell carcinoma: intermediate-term results. Radiology. 2014;270(3):880. doi:10.1148/radiol.13130275. A study comparing radical nephrectomy and microwave ablation showing comparable oncologic results for nephrectomy and microwave ablation and no major complications for microwave ablation.

    Article  PubMed  Google Scholar 

  42. Guan W, Bai J, Liu J, Wang S, Zhuang Q, Ye Z, et al. Microwave ablation versus partial nephrectomy for small renal tumors: intermediate-term results. J Surg Oncol. 2012;106(3):316. doi:10.1002/jso.23071.

    Article  PubMed  Google Scholar 

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Correspondence to S. William Stavropoulos.

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Benjamin J. Shin, Jeffrey Forris Beecham Chick, and S. William Stavropoulos each declare no potential conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Minimally Invasive Surgery

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Shin, B.J., Chick, J.F.B. & Stavropoulos, S.W. Contemporary Status of Percutaneous Ablation for the Small Renal Mass. Curr Urol Rep 17, 23 (2016). https://doi.org/10.1007/s11934-016-0581-7

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  • DOI: https://doi.org/10.1007/s11934-016-0581-7

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