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Title: CIRSE Guidelines on Percutaneous Ablation of Small Renal Cell Carcinoma

Abstract

No abstract prepared.

Authors:
 [1];  [2];  [3];  [4];  [3]
  1. Cambridge University Hospitals NHS Foundation Trust, Department of Radiology (United Kingdom)
  2. European Institute of Oncology, Unit of Interventional Radiology (Italy)
  3. Guy’s and St Thomas’ NHS Foundation Trust, Department of Radiology (United Kingdom)
  4. Klinikum Munich, Department of Diagnostic and Interventional Radiology, Neuroradiology and Nuclear Medicine (Germany)
Publication Date:
OSTI Identifier:
22645325
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 40; Journal Issue: 2; Other Information: Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ABLATION; CARCINOMAS; KIDNEYS; RECOMMENDATIONS

Citation Formats

Krokidis, Miltiadis E., E-mail: mkrokidis@hotmail.com, Orsi, Franco, Katsanos, Konstantinos, Helmberger, Thomas, and Adam, Andy. CIRSE Guidelines on Percutaneous Ablation of Small Renal Cell Carcinoma. United States: N. p., 2017. Web. doi:10.1007/S00270-016-1531-Y.
Krokidis, Miltiadis E., E-mail: mkrokidis@hotmail.com, Orsi, Franco, Katsanos, Konstantinos, Helmberger, Thomas, & Adam, Andy. CIRSE Guidelines on Percutaneous Ablation of Small Renal Cell Carcinoma. United States. doi:10.1007/S00270-016-1531-Y.
Krokidis, Miltiadis E., E-mail: mkrokidis@hotmail.com, Orsi, Franco, Katsanos, Konstantinos, Helmberger, Thomas, and Adam, Andy. Wed . "CIRSE Guidelines on Percutaneous Ablation of Small Renal Cell Carcinoma". United States. doi:10.1007/S00270-016-1531-Y.
@article{osti_22645325,
title = {CIRSE Guidelines on Percutaneous Ablation of Small Renal Cell Carcinoma},
author = {Krokidis, Miltiadis E., E-mail: mkrokidis@hotmail.com and Orsi, Franco and Katsanos, Konstantinos and Helmberger, Thomas and Adam, Andy},
abstractNote = {No abstract prepared.},
doi = {10.1007/S00270-016-1531-Y},
journal = {Cardiovascular and Interventional Radiology},
number = 2,
volume = 40,
place = {United States},
year = {Wed Feb 15 00:00:00 EST 2017},
month = {Wed Feb 15 00:00:00 EST 2017}
}
  • IntroductionThe authors compared the oncologic outcomes of radiofrequency ablation (RFA) with robotic-assisted partial nephrectomy (RPN) for the treatment of T1 stage renal cell carcinoma (RCC).Materials and methodsThis was a retrospective data analysis of a high-volume single tertiary centre. Patients were treated with RFA or RPN following multidisciplinary decision making. Only histologically proven RCCs were included. Baseline demographics were collected, and PADUA scores of tumour features were calculated to standardize baseline anatomy. Peri-operative complications, kidney function and oncological outcomes were compared.ResultsSixty-three cases were included in each group. Baseline renal function was poorer in RFA, and 16/63 RFA patients had tumours inmore » single kidneys compared to 1/63 RPN cases (p < 0.001). Length of stay was shorter in RFA (1 vs. 3 days, p < 0.0001). Post-procedure renal function decline at 30 days was significantly less in RFA [(−0.8) ± 9.6 vs. (−16.1) ± 19.5 mls/min/1.73 m{sup 2}; p < 0.0001]. More minor complications were recorded in RPN (10/63 vs. 4/63, p = 0.15), but local recurrence was numerically higher in RFA (6/63 vs. 1/63, p = 0.11). Disease-free survival (DFS) was not significantly different (adjusted HR = 0.6, 95 % Cl 0.1–3.7; p = 0.60). Increasing tumour size was an independent predictor of local recurrence (adjusted HR = 1.7; 95 % Cl 1.1–2.6 per cm; p = 0.02).ConclusionsBoth RPN and RFA offer very good oncological outcomes for the treatment of T1 RCC with low peri-operative morbidity and similar oncologic outcomes. RFA demonstrated fewer peri-operative complications and better preservation of renal function, whereas RPN had an insignificantly lower local recurrence rate. RFA should be offered alongside RPN for selected cases.« less
  • A 64-year-old man with a unilateral 15 mm diameter renal cell carcinoma underwent percutaneous radiofrequency ablation (RFA) assisted by CT during renal arteriography (angio-CT). Prior to placement of the needle electrode, a 5 Fr angio-catheter was placed in the right renal artery, and angio-CT was performed before, during and after the procedure. Since multiple angio-CT can be performed using a small amount of diluted contrast agent, RFA can be monitored without impairing renal function. As a result, this imaging combination was found to be useful for determining the end point of ablation.
  • We performed percutaneously radiofrequency (RF) ablation of 5 renal cell carcinomas (mean diameter 26 {+-} 15 mm) with computed-tomography (CT) fluoroscopic guidance using the transhepatic route. The RF electrode was successfully advanced into all tumors. RF ablation caused one minor complication (small asymptomatic perirenal hematoma); no major complications occurred. The follow-up contrast-enhanced CT images showed no local tumor progression of any tumors in a median period of 10 months (range 3-14 months). In conclusion, it seems that this transhepatic approach is safe and can be an alternative method for electrode insertion during RF ablation of selected renal tumors.
  • The purpose of this study was to determine the safety, effectiveness, and feasibility of microwave ablation (MWA) of small renal cell carcinomas (RCCs) in selected patients. Institutional review board and informed consent were obtained. From December 2007 to January 2009, 12 patients (8 male, 4 female) were enrolled in a treatment group, in which percutaneous MWA of small RCCs was performed under contrast-enhanced ultrasound guidance. The tumors were 1.7-2.9 cm in diameter (mean diameter, 2.0 cm).Therapeutic effects were assessed at follow-up with computed tomography. All patients were followed up for 3-14 months (mean, 6 months) to observe the therapeutic effectsmore » and complications (according to SIR classification). Assessment was carried out with CT imaging. No severe complications or unexpected side effects were observed after the MWA procedures. In all cases technical success was achieved. Clinical effectiveness was 100%; none of the patients showed recurrence on imaging. In conclusion, our preliminary results support the use of MWA for the treatment of small renal tumors. This technology can be applied in select patients who are not candidates for surgery, as an alternative to other ablative techniques.« less
  • Percutaneous radiofrequency ablation (RFA) has gained wide acceptance as nephron-sparing therapy for small renal masses in select patients. Generally, it is a safe procedure with minor morbidity and acceptable short-term oncologic outcome. However, as a result of the close proximity of vital structures, such as the bowel, ureter, and large vessels, to the ablative field, complications regarding these structures may occur. This is the first article describing appendiceal perforation as a complication of computed tomography-guided RFA despite hydrodissection. When performing this innovative and promising procedure one should be aware of the possibility of particular minor and even major complications.