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Tuesday, September 30, 2014

Radiofrequency ablation of renal cell carcinomas: outcomes and predictors of efficacy

With the incidence of RCC on the rise, ablative techniques have become more commonplace. However, the existing body of literature is limited by studies that are small in size, have varied ablative techniques, or lack pathology of the lesion (benign vs. malignant). By retrospectively evaluating 100 path-proven RCCs treated with percutaneous RFA only, researchers at UCLA have aimed to better understand predictors of successful treatment and outcomes of RF ablation of RCCs.

By using the RENAL nephrometry score, a tool for standardizing the description of renal masses, the authors sought to determine which tumor characteristics were most predictive of treatment success. This tool is comprised of five components, Radius, Exophytic/Endophytic, Nearness of tumor to collecting system or sinus, Anterior/Posterior, and Location relative to polar lines. The authors found that the overall RENAL score predicted the ability to achieve complete tumor ablation after one session with no evidence of local tumor progression on follow-up imaging. Of the RENAL score components, Radius (size) and Location correlated with successful outcome.

At a follow-up of 2.1 years, the authors found an overall 95% success rate in treating these tumors, although 9% of tumors required a second ablation to obtain a complete response. 98.7% of patients remained free of metastasis and no patient died as result of their RCC, figures which are consistent with existing data. Although other ablative techniques are gaining popularity, RF remains the most proven modality for the treatment of renal cell carcinoma.

Click here to see the full abstract

USEFUL LINK: RENAL Nephrometry Score Calculator (http://www.nephrometry.com)

Citation: McClure, T. D. et al. Intermediate Outcomes and Predictors of Efficacy in the Radiofrequency Ablation of 100 Pathologically Proven Renal Cell Carcinomas. Journal of Vascular and Interventional Radiology (2014).

Post author: Amish Patel, MD

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