Long-term outcomes after percutaneous radiofrequency ablation for renal cell carcinoma.

OBJECTIVES

To assess the long-term oncological efficacy of radiofrequency ablation (RFA) for treatment of renal cell carcinoma (RCC).

METHODS

In this institutional review board-approved, retrospective study, the records and imaging studies for all RCC patients treated with percutaneous RFA before 2005 were reviewed and analyzed.

RESULTS

A total of 48 RCCs in 41 patients were treated with RFA. Median size of RCC treated was 2.6 cm (range: 0.7-8.2 cm). Of the 48 treated RCCs, 5 (12%) had recurrent tumor after a single ablation session. The median size of the index lesion in the cases with recurrence was 5.2 cm (interquartile range [IQR]: 4-5.3) compared with 2.2 cm (IQR: 1.7-3.1, P = .0014) without local recurrence. There were no recurrences when RCCs less than 4 cm were treated. Seventeen (41%) patients with 18 treated RCCs died during the follow-up period at a median time of 34 (IQR: 10-47) months. One patient (2%) died of metastatic RCC, whereas 16 died of unrelated causes. Twenty-four patients with 30 RCCs treated with RFA survived. For the remaining 30 RCCs, median follow up was 61 months (IQR: 54-68). No patients in this group of survivors had metastatic RCC, 1 had recurrence diagnosed at 68 months. The long-term recurrence-free survival rate was 88% after RFA.

CONCLUSIONS

RFA can result in durable oncological control for RCCs less than 4 cm. RFA is an effective treatment option for patients with RCCs less than 4 cm who are poor surgical candidates. For patients with larger RCCs alternative treatments should be considered.