ANAHEIM, CaliforniaPercutaneous radiofrequency ablation, which is
FDA-approved for treating liver and soft tissue neoplasms, may also be useful
in renal cell carcinoma, according to several reports from the American
Urological Association annual meeting.
Investigators from both the National Cancer Institute and Harvard Medical
School concluded that the procedure is a safe and minimally invasive option for
the treatment of select, small renal neoplasms, although more rigorous
long-term follow-up is necessary before routinely adopting this modality.
"Small renal cell carcinomas are being detected at an ever-increasing
rate, mostly in persons having CT scans for other purposes," said Francis
J. McGovern, MD, of Harvard Medical School and Massachusetts General Hospital.
These are often early-stage cancers that are fairly easy to treat. "But
we are also finding incidental renal tumors in older patients with multiple
comorbidities. These patients are often limited to watchful waiting, which can
be quite anxiety provoking. Radiofrequency ablation offers a treatment option
to patients who are at high surgical risk," he said.
Dr. McGovern and his colleagues (abstract 645) evaluated the safety and
efficacy of radiofrequency interstitial tumor ablation in 17 patients with 19
renal cell tumors ranging from 1 to 5.5 cm.
Ablations were performed as outpatient procedures using intravenous sedation
and an internally cooled radiofrequency electrode, with image guidance by
ultrasound or CT scan. Responses were evaluated by contrast-enhanced CT or MRI,
and follow-up averaged 3.5 years.
In 18 tumors treated with curative intent, complete responses were seen in
15 lesions and partial responses in the remaining 3 lesions. In all complete
responders, the tumors were peripheral or exophytic, and ranged from 1 to 3.5
cm in greatest diameter. Larger tumors in the periphery also responded well. In
all partial responders, tumors were larger (4.4 to 5.5 cm) and centrally