Residual And Recurrent Disease Following Renal Energy Ablative Therapy: A Multi-Institutional Study

December 7, 2006 – 10:37 am | posted in Urology / Nephrology

UroToday.com - Even as the use of ablative strategies for renal masses such as radiofrequency ablation (RFA) and cryoablation has continued to expand, no guidelines have been proposed for patient follow-up based on the risk of the recurrence.

In the November issue of the Journal of Urology, Matin and colleagues present data from a multi-institutional study designed to evaluate the recurrence patterns after renal RFA.

Data from 7 institutions were compiled for a total of 616 patients who underwent renal cryoablation or RFA. Different schedules for surveillance had been used at each institution based on preference.

After a mean follow-up of 2 years, 13.4% of patients developed recurrence after renal RFA and 3.9% recurred after cryoablation, for a median recurrence rate of 8.7%. Seventy percent of those patients with incompletely treated tumors were identified within the first 3 months of treatment. Over 95% of patients with treatment failure were salvaged with a renal ablative strategy. The overall 2-year metastasis free survival was 97% for patients with localized, unilateral tumors.

The authors are to be congratulated for collaborating for the benefit of proposing recommendations for risk-based surveillance. These data suggest that the majority of patients with treatment failure will be identified within 3 months. Contrast enhanced imaging studies were recommended at months 1, 3, 6 (optional), and 12 months in the first year after treatment.

Matin SF, Ahrar K, Cadeddu JA, Gervais DA, McGovern FJ, Zagoria RA, Uzzo RG, Haaga J, Resnick MI, Kaouk J, Gill IS

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