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Radiofrequency Ablation of a Kidney Tumor
WINSTON-SALEM, N.C. – Studies of patients with kidney cancer have shown that radiofrequency ablation, a minimally invasive, kidney-sparing procedure, can be a successful treatment option for patients whose cancer has not spread beyond the kidney.
The treatment uses computed tomography for guidance during percutaneous placement of a needle-shaped electrode into the tumor. Radiofrequency current is then passed through the electrode to heat the tumor tissue and ablate – or eliminate – it.
In the majority of patients complete tumor ablation can be achieved after a single treatment; others achieved complete tumor ablation after two or more treatments, with no long-term or serious complications.
"This is significant and encouraging because the incidence of kidney cancer in the United States has increased by 126 percent over the past 50 years," said Ronald J. Zagoria, professor of Radiologic Sciences at Wake Forest Baptist and a nationally-recognized expert on radiofrequency ablation.
For the past 50 years, the standard of care for kidney cancer has been radical nephrectomy – removal of the kidney. More recently, partial nephrectomy has been shown to have equivalent results for curing small low-stage renal cancers, indicating that kidney-sparing procedures can be curative. However, nephrectomy is not ideal for many patients, such as those who cannot tolerate surgery because of other health-related conditions.
Advances in imaging techniques have resulted in detecting the tumors when they are much smaller, often in patients who show no symptoms. The success of radiofrequency ablation in treating kidney cancer is largely dependent on tumor size.
In a large study led by Zagoria, tumors smaller than 3.7 cm in diameter were completely ablated with a single outpatient treatment. Residual tumor was found only in patients with tumors greater than 3.7 cm, suggesting that larger tumors are more difficult to eradicate completely with radiofrequency ablation.
"While radical or partial nephrectomy is still the primary treatment of choice, radiofrequency ablation offers us another potentially curative option for appropriate patients," said Zagoria.
While additional studies are needed to determine its long-term success, it has proven to be a useful treatment for patients who are not ideal surgical candidates. In addition, the length of hospital stay, cost and risk of complications for radiofrequency ablation are projected to be less than for nephrectomy.
