TY  - EJOU
AU  - Raman, Jay D. 
AU  - Thomas, James 
AU  - Lucas, Steven M. 
AU  - Bensalah, Karim 
AU  - Lotan, Yair 
AU  - Trimmer, Clayton 
AU  - Cadeddu, Jeffrey A. 

TI  - Radiofrequency ablation for T1a tumors in a solitary kidney: promising intermediate oncologic and renal function outcomes
T2  - Canadian Journal of Urology

PY  - 2008
VL  - 15
IS  - 2
SN  - 1488-5581

AB  - <b>Objective:</b> The experience with radiofrequency ablation (RFA) in solitary kidneys is limited in numbers and follow-up. Therefore, we report our oncologic and renal function outcomes of RFA for T1a tumors in patients with a solitary kidney.<br/>
<b>Methods:</b> From April 2000 to August 2007, 242 patients were treated with RFA for renal cortical masses. Sixteen patients with localized tumors ≤ 4 cm in a solitary kidney were identified. Clinical and radiographic data were reviewed to assess indications, complications, disease recurrence, and renal function.<br/>
<b>Results:</b> Twenty-one renal masses were ablated in 16 patients with a solitary kidney. The mean patient age was 66.1 years, and the mean tumor size was 2.6 cm (range, 1.1-4.0). Preoperative biopsy was diagnostic of renal cell carcinoma (RCC) in 75% of cases. At a mean follow-up of 30.7 months (range, 1.5-66.0), 14/16 (88%) patients had no radiographic evidence of disease recurrence. One patient with three masses in a solitary kidney had a local recurrence managed by salvage RFA. The other patient with a local failure also had severe baseline renal insufficiency with progression to end stage renal disease 2.5 years following RFA and underwent a radical nephrectomy. Mean glomerular filtration rate (GFR) decreased from 54.2 ml/min/1.73m<sup>2</sup> preoperatively to 47.5 ml/min/1.73m<sup>2</sup> at last follow-up (p = 0.015). There were no major complications, and four patients had minor complications which resolved without intervention.<br/>
<b>Conclusion:</b> Radiofrequency ablation is an attractive alternative for the management of patients with T1a renal cortical tumors in a solitary kidney. Renal function appears to be adequately maintained with promising oncologic outcomes at 2.5 years.
KW  - glomerular filtration rate (GFR)
KW  -  kidney mass
KW  -  renal cell carcinoma (RCC)
KW  -  RFA
KW  -  thermal ablation

DO  -