Long-Term Outcomes of Percutaneous Radiofrequency Ablation of Small Renal Tumours

Abstract

Background: Ablation technique is relatively new nephron-sparing treatment of small renal masses (SRM). It carries a lower complication rate and lower overall healthcare costs compared with surgery. However, there are only a few studies with long-term follow up. Therefore, further studies are needed to evaluate the long-term oncological outcome of percutaneous radiofrequency ablation therapy before this method can be applied on a general population of patients with SRM. Methods: A retrospective evaluation was done on 101 patients with small renal tumours who were treated with percutaneous radiofrequency ablation (RFA) between 2002 and 2013 at Sahlgrenska University Hospital. The long-term outcomes of these procedures were studied and data was collected from patients’ medical records. Results: The Median follow-up time was 8.5 years. The total proportion of local recurrences was (17%). Five of them (29%) appeared during the sixth year of the follow-up. Also, the median time to local recurrence was 26 months. Three new metastases were detected under the follow-up time and no late complications registered in this study. The median overall survival for the material was 9.0 years. Conclusions: RFA has a good clinical value as a nephron-sparing method treating small renal tumours. Long-term results showed no late complications and relatively low metastasis and late recurrence rate. However, due to late occurring recurrences, longer follow-up than the standard of five years used after cancer surgery is required after RFA of SRM. Patient selection based on tumour characteristics, co-morbidity and estimated residual life is of paramount importance.