Learning objectives
To present the indications, the procedure and the results of radiofrequency ablation of renal tumors.
To consider the risks and the possible complications of the procedure.
To discuss about the different approachments of renal tumors
Background
Renal cell carcinoma (RCC) is a common cancer that is increasing in incidence because of the increased prevalence of risk factors, including tobacco use, hypertension, and obesity, and the improved detection of these tumors due to increased use of imaging [1,2] . The observed annual increase in the incidence of small renal tumors (approximately 2%) can partly be attributed to the rapid progress in tomographic imaging. The detection of the tumor in the early T1a stage (48–65%) as an incidental finding is advantageous as it...
Findings and procedure details
The heating mechanism in RFA is to induce tissue heating through ohmic dissipation (Joule effect) and ionic agitation. The local heat produced induces a coagulation necrosis of the tumor tissue. By applying high-frequency alternating current (400–460 kHz), oscillation of ions is induced in the target tissue, creating temperatures of 60–90°C. The resulting protein denaturation is irreversible [5]. The cytotoxic effect of RFA depends on the maximum temperature achieved and the duration of the ablation. The entire tumor volume plus a 5–6mm wide safety margin has...
Conclusion
RFA of renal tumors is a technique that plays a major role in many urologic oncology practices, palliative as well as curative, according to the recent American and European Urology guidelines. The number of RFA and other invasive non-operative treatments (CA, MWA) for localized renal tumors is progressively increasing, with excellent results in terms of efficacy and safety.
Personal information and conflict of interest
A. Kolovou; Athens/GR - nothing to disclose C. Charalambous; Athens/GR - nothing to disclose E. Nikolentzou; Athens/GR - nothing to disclose N. Roppa- Lepida; Athens/GR - nothing to disclose A. Lourbakou; Athens/GR - nothing to disclose S. Mylona; Athens/GR - nothing to disclose E. Pierratou; Athens/GR - nothing to disclose
References
Regier M, Chun F: Thermal ablation of renal tumors: indications, techniques and results. Dtsch Arztebl Int 2015; 112: 412–8. DOI: 10.3238/arztebl.2015.0412
Ward RD, Tanaka H, Campbell SC, Remer EM: 2017 AUA Renal Mass and Localized Renal Cancer Guidelines: Imaging Implications. Radiographics. 2018 Nov-Dec;38(7):2021-2033.
Yin X, Cui L, Li F, Qi S, Yin Z, Gao J: Radiofrequency AblationVersus Partial Nephrectomy in Treating Small RenalTumors: A Systematic Review and Meta-Analysis. Medicine (Baltimore).2015 Dec;94(50): e2255
Sommer CM, Vollherbst DF, Richter GM, Kauczor HU, Pereira PL: What can/should be...