A recent article in the journal Urology reports that radio frequency ablation (RFA) may produce short-term benefits for patients with small renal tumors.
The kidneys are each filled with tiny tubules that clean and filter the blood to remove waste and make urine. Renal cell cancer is a malignancy involving these tubules of the kidney.
Treatment for renal cell carcinoma can be extensive and may be associated with poor outcomes. The four basic treatment options for the disease include: surgery, radiation, chemotherapy and biologic therapy. In addition, some cancers affecting these areas of the kidney can be eliminated by a technique called radiofrequency ablation (RFA). RFA is a minimally invasive technique that uses heat to destroy cancerous cells. During RFA, CT scans, ultrasound or laparoscopy guide electrode placement directly into the tumor. The electrode’s high frequency radio waves create intense heat, which destroy the tumor cells. Radiofrequency ablation has been demonstrated to be effective in eradicating small renal cell cancers near the surface of the kidney in individuals who are not good candidates for surgery.
This recent study focused on the short-term benefit (1 to 3 years) of RFA for the treatment of small renal tumors. Patients diagnosed with renal tumors were treated with RFA guided either by CT scans or by laparascopy. Each patient received repeat imaging scans at 6 weeks and again at 3 and 6 months. Scans were continued every 6 months from that point forward.
The 91 patients treated in the study had an average tumor size of 2.4 cm. Among these participants, 98 percent of tumors were destroyed (107 of 109 tumors treated-some patients had more than one tumor). The remaining two tumors retreated and were then successfully destroyed. Sixty patients-the majority-had been diagnosed with renal cell cancer at least 1 year prior to undergoing RFA as part of this study. Some had biopsy-proven renal cell cancer, while others lacked a biopsy-proven diagnosis. Among the 60 patients in this group, one patient had a localized recurrence of disease after 19.4 months of follow-up, however this was successfully reablated. At last follow-up, all patients had no clinical or radiographic evidence of remaining disease.
Researchers concluded that although longer follow-up is needed before widespread application of these results can be implemented, RFA appears to be a reasonable approach for select patients with smaller renal tumors. This is already a very important technique for individuals whose overall health makes them unsuitable for surgery.
Reference: Matsumoto E, Johnson B, Ogan K, et al. Short term efficacy of temperature based radiofrequency ablation of small renal tumors. Urology; 65: 877-881.
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