Category: MIS Image Guided/ Focal-cryo/RFA/HIFU: Kidney
Introduction & Objective :
We sought to review long-term oncological outcomes of patients with renal tumors treated with radiofrequency ablation (RFA) greater than 10 years ago.
Patients with renal tumors that underwent RFA from November 2000 to August 2007 were reviewed retrospectively. Demographic, clinical, and radiologic data were assessed to determine evidence for recurrence of disease. Patients with familial renal cell carcinoma syndromes were excluded from the study. Disease-free survival (DFS), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS) were calculated with the Kaplan-Meier method. Subgroup analysis of patients that had at least 10 years follow-up was performed to determine actual 10-year survival. Analysis was also performed based on tumor size.
A total of 112 tumors in 106 patients underwent RFA. Median follow-up was 79 months (IQR 28.9 – 121.1) and mean tumor size was 2.5 cm ± 0.8. Initial technical success was achieved in 97% of cases. There were 10 recurrences. Actuarial six-year disease-free survival and cancer-specific survival was 89% and 96%, respectively. DFS drops to 68% for tumors greater than 3 cm (figure 1). Within the subgroup that had at least 10-year follow-up, actual DFS, CSS, and OS were 82%, 94%, and 49%, respectively (figure 2). No patient recurred after 5 years.
RFA is a safe and effective treatment option for small renal masses less than 3 cm in diameter. We report good oncologic outcomes with actual 10-year survival data. No recurrences occurred after 5 years. Tumors greater than 3 cm have significantly poorer outcomes.
Brett Johnson, is the current second-year Endourology fellow at University of Texas Southwestern with Drs. Jeffrey Cadeddu and Margret Pearle. He completed residecny in Urology at the University of Wisconson.
Ryan L. Steinberg MD is a fellow in Endourology and Minimally Invasive Surgery at the University of Texas Southwestern.