[Percutaneous radiofrequency ablation of the renal tumors. Initial clinical experience with minimally invasive therapy].

UNLABELLED

AIM OF THE ARTICLE: To evaluate first clinical and interventional radiological features and experience with computed tomography-guided percutaneous radiofrequency ablation of the renal tumors using StarBurst instruments (RITA Medical System, Inc., Mountain View, CA).

METHODS

The group of 8 patients with mean age 77.75 +/- 4.38 years underwent during a period of 12 months CT-guided RFA treatments for enhancing renal masses, with a mean size 21.78 +/- 9.81 mm, using only conscious sedation and local anaesthesia. All patients had multiple medical comorbidities that limited or completely contraindicated surgical treatment. In two cases tumors involved solitary kidney. Patients were hospitalized in urologic department of University hospital, where possible early complications were monitored. Patients were followed with clinical status and renal function studies. Also enhanced imaging (enhanced computed tomography or magnetic resonance in one case) were performed 1 month, 3, 6 and 12 months after initial procedure. Successful ablation was defined as a lack of enhancement of the renal mass eventually with a scar-like retraction of surrounding renal parenchyma.

RESULTS

During a 12-months period (from February 2006 to February 2007) 10 percutaneous CT-guided RFA treatments in 8 patients were performed. In 6 patients (75%) were single treatment successful, 1 had an initial failure and underwent reablation successfully and 1 underwent second treatment for coexisting small tumor in the same kidney. All patients stayed in hospital for a 3 days, none from this group died during this period and none need not to be excluded from this study. We did not reveal any early complication. Average length of the following-up was 5.75 months.

CONCLUSIONS

CT-guided percutaneous radiofrequency ablation is a promising therapeutic alternative of surgical methods (nephrectomies or nephron-sparing surgical devices) especially with small renal tumors in patients with multiple medical comorbidities, tumors in solitary kidneys and in rarer indications. The procedure were well tolerated using only conscious sedation and local anaesthesia. None early complication was observed. Other useful informations will be probably captured by following-up this group and by monitoring new patients.