Radiofrequency ablation of renal tumors in the solitary kidney
Krambeck E. Amy; Farrell A. Michael; Callstrom R. Matthew; Atwell D. Thomas; Charboneau William J.; Chow K. George; DiMarco S. David; Patterson E. David;
Department of Urology, Mayo Medical School and Mayo Clinic, Rochester, Minnesota, USA
OBJECTIVES: Radiofrequency ablation (RFA) is a minimally invasive therapy aimed at maximal preservation of renal function in the nonsurgical renal mass patient. We evaluate our experience with RFA of renal tumors in the solitary kidney.
PATIENTS AND METHODS: A retrospective review of all patients with a solitary kidney treated with RFA for renal mass was performed. Two radiologists reviewed all images. From December 2001 to June 2006, 55 renal tumors were treated with RFA in 30 patients with a solitary kidney. Percutaneous approach was used in 44 tumors (26 patients) and intraoperative open approach in 11 tumors (4 patients). Average mass size was 2.0 cm (1.2-5.4). Biopsy performed prior to ablation in 14 tumors showed renal cell carcinoma in 12 (86%) and was non diagnostic in 2 (14%).
RESULTS: There were no major post procedural complications. Initial technical success was noted in 98% of tumors in 97% of patients. Average follow-up with contrast enhanced CT or MRI was 25 months (3-47) in 26 patients (50 tumors) and showed local tumor control in 100%. No difference in preoperative and postoperative calculated creatinine clearance was noted (p = 0.072). There was no difference in systolic (p = 0.102) and diastolic (p = 0.790) blood pressure pre and post ablation.
CONCLUSIONS: RFA of renal masses in the solitary kidney appears to be a safe, minimally invasive alternative to open surgical resection in properly selected patients. Local tumor control was achieved with no adverse effects on renal function and blood pressure in this series.