Percutaneous CT-Guided Radiofrequency Ablation of Solitary Small Renal Masses: A Single Center Experience

Abstract

Purpose: To analyze the outcome of patients undergoing percutaneous CT-guided radiofrequency ablation (RFA) of small renal masses (SRM) at a single center during a ten-year time period. Materials and Methods: Patient records of renal RFAs (07/2003-11/2013) were reviewed. Indications were SRM suspicious of malignancy on imaging and one of the following: severe comorbidity; old age; solitary kidney; impaired renal function; patient wish. Biopsy was performed at the time of RFA. Patients were excluded if no follow-up was available. Patient and procedural characteristics were recorded. Survival rates were calculated using the Kaplan-Meier's method and compared with log-rank or cox tests. Results: 38 patients (16 females, mean age 70.0 years [range 52-87]) presenting with a solitary SRM were included in the study. Biopsy showed malignancy in 29 patients; 9 had benign tumors. 26 patients suffered from cardiovascular, respiratory or hepatic comorbidities. Technical success (complete ablation on first follow-up) was achieved in 95% of cases. Two major complications (bowel perforation; hematothorax) occurred. The 3- and 7-year overall survival (OS) [any cause] rates were 73.4±0.8% and 50.3±1.0%, respectively (mean follow-up 54.6 months, range 1-127). 4 recurrences and 2 metastases were observed. The presence of comorbidities was the only independent predictor of OS.There was no difference in survival between patients with benign and malignant tumors. Conclusion: RFA of SRM is successful in a large percentage of cases with a low complication rate and durable local control. As RFA is typically performed in multimorbid patients, overall survival seems to depend primarily on comorbidities rather than cancer progression. Key Points • RFA of SRM is technically successful in the majority of cases. • RFA leads to a high degree of local tumor control. • Post-RFA most patients ultimately die of comorbidities. • Overall survival post-RFA does not significantly differ between benign and malignant tumors in multimorbid patients. Citation Format: • Pieper C. C., Fischer S., Strunk H. etal. Percutaneous CT-Guided Radiofrequency Ablation of Solitary Small Renal Masses: A Single Center Experience. Fortschr Röntgenstr 2015; 187: 577-583