Gervais DA et al. (2005) Radiofrequency ablation of renal cell carcinoma: part 1, indications, results, and role in patient management over a 6-year period and ablation of 100 tumors. AJR 185: 64–71

Gervais and colleagues have recently reported on their experience of radiofrequency ablation as an alternative to surgery in patients with renal cell carcinoma. The findings suggest that this minimally invasive technique is useful in those for whom conventional nephrectomy is inappropriate, and that small, noncentral tumors are most likely to respond favorably to treatment.

During a 6-year period, the team performed radiofrequency ablation on 100 renal tumors in 85 patients. The mean size of the tumors was 3.2 cm (range 1.1–8.9 cm). Multiple, overlapping ablations were carried out where needed, and repeat sessions were used if residual tumor was detected by CT or MRI after treatment. The procedure was carried out on an outpatient basis in most cases.

Complete tumor necrosis was observed in 90% of the tumors, and the mean diameter of these successfully treated tumors was 2.9 cm (range 1.1–5.5 cm). Multivariate analysis showed that small tumor size was an independent predictor of complete necrosis after a single ablation session, and a trend was shown between small tumor size and successful treatment after multiple sessions. Noncentral location was independently associated with complete necrosis after a single session of ablation or after multiple sessions. All exophytic tumors were completely ablated, whereas those in a central location or with central and exophytic components were successfully treated in 78% and 61% of cases, respectively.