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Radiofrequency ablation of small renal cortical tumours in healthy adults: renal function preservation and intermediate oncological outcome.
- Source :
-
BJU international [BJU Int] 2009 Sep; Vol. 104 (6), pp. 786-9. Date of Electronic Publication: 2009 Apr 04. - Publication Year :
- 2009
-
Abstract
- Objectives: To present the glomerular filtration rate (GFR) and oncological outcomes in a series of patients with cT1a renal cortical tumours treated with radiofrequency ablation (RFA), a non-ischaemic minimally invasive ablative method, as nephron-sparing surgery gives excellent oncological outcomes and preserves renal function.<br />Patients and Methods: Healthy (American Society of Anesthesiologists, ASA, I and II) patients with cT1a renal masses were identified, and clinical and radiographic data were reviewed to assess indications, complications, radiological evidence of disease recurrence, and renal function. Changes in GFR were calculated. Radiological recurrence was defined as any new enhancement (>10 Hounsfield units) after absence of enhancement on initial 6-week computed tomography.<br />Results: Four patients were ASA I and 59 were ASA II; the median (range) age was 58 (20-84.6) years and the lesion diameter 2.1 (1-4.0) cm. Preoperative needle biopsy was diagnostic in 89% of patients, including 75% diagnostic of renal cell carcinoma (RCC). At a median (range) follow-up of 34 (1.0-80) months the renal preservation rate was 97%. One patient had a nephrectomy for biopsy-confirmed recurrence of RCC at 55 months; a second had a nephrectomy at 24 months for suspected radiographic recurrence, but had no evidence of disease on final pathology. A fifth (20%) of the patients had chronic kidney disease at the time of diagnosis. The median GFR before and after RFA was 76.3 and 74.3 mL/min/m(2) (difference 2.0 mL/min/m(2)).<br />Conclusion: RFA might be a reasonable treatment choice for the healthy patient, with appropriate informed consent. Intermediate results suggest excellent oncological outcomes and preservation of renal function.
- Subjects :
- Adult
Aged
Aged, 80 and over
Carcinoma, Renal Cell pathology
Carcinoma, Renal Cell physiopathology
Dihydrolipoamide Dehydrogenase metabolism
Female
Humans
Kidney Neoplasms pathology
Male
Middle Aged
Neoplasm Recurrence, Local
Retrospective Studies
Treatment Outcome
Young Adult
Carcinoma, Renal Cell surgery
Glomerular Filtration Rate physiology
Kidney physiology
Kidney Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1464-410X
- Volume :
- 104
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- BJU international
- Publication Type :
- Academic Journal
- Accession number :
- 19426196
- Full Text :
- https://doi.org/10.1111/j.1464-410X.2009.08443.x