No Evidence Of Disease After Radiofrequency Ablation In Delayed Nephrectomy Specimens

January 1, 2007 – 10:14 am | posted in Cancer / Oncology, Radiology, Urology / Nephrology

UroToday.com - One of the obvious limitations of the ablative technologies (radiofrequency ablation (RFA) and cryotherapy) is the reliance on radiographic criteria (lack of enhancement) to define success and effective tumor ablation. Recent reports of persistent viable tumor in tumors resected for a variety of indications after ablative therapy have hampered the widespread acceptance of these technologies into general practice. Here, the group from UT Southwestern reviews the findings of patients that have undergone delayed tumor resection after RFA, to examine the pathologic findings and correlate them with radiographic criteria.

Of 193 tumors that have been treated with RFA, the authors report on 3 patients who underwent delayed tumor excision. Two patients underwent delayed nephrectomy due to the development of new “peripheral” enhancement at the site of RFA during follow-up surveillance. One patient underwent nephrectomy due to a UPJ obstruction that was a direct complication of the RFA procedure. All patients had biopsy proven renal cell carcinoma prior to tumor ablation. Mean time from ablation to nephrectomy was 18 months. All specimens were examined pathologically and none demonstrated residual tumor, including the two patients with “peripheral enhancement” on radiographic imaging. These specimens demonstrated a granulomatous reaction in this area but no viable tumor.

Ideally, a clinical trial where patients undergo tumor ablation followed by delayed tumor resection to determine the efficacy of these treatment approaches should be performed, but many have argued that an “ablate and resect” trial could not logistically or ethically be completed. The cases presented in this study demonstrate that not all post-ablation radiographic enhancement represents recurrent or residual tumor, although with this very limited number of patients, hard conclusions cannot be drawn. Further experience and follow-up is necessary to determine the long term oncologic efficacy of these technologies in the treatment of small renal masses.

Park S, Strup SE, Saboorian H, Cadeddu JA

Urology 68: 964-967, 2006.
Reviewed by UroToday.com Contributing Editor Christopher G. Wood, MD, FACS

UroToday - the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice.

To access the latest urology news releases from UroToday, go to:
www.urotoday.com

Copyright © 2006 - UroToday

ShareThis

Also Read

  • Is Radiofrequency Ablation Safe For Solitary Kidneys
  • RF Ablation Effective For Treating Inoperable Lung Cancer Rhode Island Hospital Study Confirms
  • Intact Specimen Extraction In Laparoscopic Nephrectomy Procedures: Pfannenstiel Versus Expanded Port Site Incisions.
  • Cryoablation: A New Treatment Option For Some Kidney Tumor Patients
  • Should Radical Nephrectomy Be Standard Of Care For Renal Cortical Tumors 4cm Or Less? Raised Incidence Of Chronic Renal Disease After Radical Nephrect
  • Long-Term Results Of Cryoablation For Renal Cancer And Complex Renal Masses
  • Significant Discrepancy Between Clinical And Pathologic Staging In Renal Cell Carcinoma
  • New Technique Invented By Doctors At Englewood Hospital Minimizes Complications Of Cardiac Ablation Procedure
  • Robotic Partial Nephrectomy For Complex Renal Tumors: Surgical Technique
  • Laparoscopic Cytoreductive Nephrectomy: The M. D. Anderson Cancer Center Experience

    • You must be logged in to post a comment.