Radiofrequency ablation of small renal masses as an alternative to nephron-sparing surgery: preliminary results

Introduction: Radical endoscopic minimal-invasive treatment methods, such as thermal ablation, are sought as analternative to standard radical surgical treatment of kidney neoplasms. We analysed patients who could be qualifiedfor radical treatment due to T1a renal tumour. Material and methods: Twenty-three patients out of 129 who underwent radiofrequency thermal ablation of kidneytumours in the years 2003-2010 were analysed. The inclusion criteria were age below 70 years, lack of major comorbidities(ASA score 1, 2), and competent contralateral kidney. In all cases tumour size was below 4 cm. All patientswere followed up with computed tomography (CT) and ultrasonography (USG) every 6 months for 3 years. Results: In 20 patients kidney tumour was biopsied before radiofrequency ablation (RFA) and 10 of these biopsies werepositive and revealed cancer. Six patients required additional treatment due to recurrence visible in CT – 3 with a positivebiopsy result, 1 with negative and 2 without biopsy. Three of them were treated with a second session of RFA,1 with radical nephrectomy and 2 with partial nephrectomy. No disease dissemination was observed and all patientswho received additional treatment remain disease free. Conclusions: The RFA can be safely used in selected patients with T1a tumour as an alternative to partial nephrectomy.Careful follow-up is required after thermal ablation and allows early detection and successful treatment of recurrences.