Radiofrequency ablation of renal tumors: Practical aspects and results

OBJECTIVES: To report our experience in percutaneous radiofrequency ablation of renal tumors, emphasizing technical aspects and indications and analyzing our results. MATERIAL AND METHODS: We retrospectively analyzed 20 tumors in 13 patients (10 with a single kidney, 2 who had refused surgical treatment, and 1 with severe comorbidities). All procedures were carried out using the radiofrequency interstitial tumor ablation (RITA) technique under general anesthesia and CT guidance. All patients underwent follow-up CT examination with and without intravenous contrast administration; the absence of enhancement was considered complete necrosis. RESULTS: The mean size of the tumors was 2.8 cm. Complete necrosis was achieved in 17 tumors (85%); complete necrosis was achieved in 100% of the exophytic tumors and in 50% of the tumors with mixed growth after 14 months' follow-up. Complete ablation was achieved in 15 of the 16 tumors measuring <= 3.5 cm. In 9 of the 10 patients with a single kidney (four of whom had more than one tumor), renal function remained normal after the procedure; the other patient developed hydronephrosis after a urinary tract lesion and died. The patient who died also developed a subcapsular liver lesion that did not require transfusion when another tumor was treated transhepatically. CONCLUSION: In experienced hands and with careful selection of patients (exophytic tumors <= 3.5 cm), radiofrequency ablation of renal tumors can achieve excellent oncologic results with minimal morbidity and mortality. (C) 2009 SERAM. Published by Elsevier Espana, S.L. All rights reserved.