Open Access

MINIMALLY INVASIVE AND ROBOTIC SURGERY

Thermal ablation of small renal masses: intermediate outcomes from a Canadian center

Petar Erdeljan¹, Mrinal Dhar², Geoff Wignall³, Roman Kozak⁴, Stephen E. Pautler^1,5

1 Division of Urology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
2 West Alabama Urology Associates, Tuscaloosa, Alabama, USA
3 GBHS Owen Sound Hospital, Owen Sound, Ontario, Canada
4 Department of Radiology and Diagnostic Imaging, The University of Western Ontario, London, Ontario, Canada
5 Division of Surgical Oncology, Department of Oncology, The University of Western Ontario, London, Ontario, Canada
Address correspondence to Dr. Stephen Pautler, Departments of Surgery and Oncology, The University of Western Ontario, St. Joseph’s Hospital, 268 Grosvenor Street, London, Ontario N6A 4V2 Canada

Canadian Journal of Urology 2011, 18(5), 5903-5907.

Abstract

Introduction: Cryoablation (CA) and radiofrequency ablation (RFA) are nephron-sparing procedures that destroy renal tissue in situ rather than by surgical removal. Both thermal ablative techniques are recommended for select patients with small renal masses and multiple comorbidities that may preclude major surgery. Unfortunately, the long-term oncologic outcomes of these procedures remain unknown.
Materials and methods: We report oncologic outcomes following CA and RFA in patients with small renal masses from a single institution over a 48-month follow-up period. A total of 30 patients underwent thermal ablation for a small renal mass: 7 received RFA and 23 underwent CA.
Results: The median tumor size on preoperative CT was 2.6 cm ± 0.87 cm. Four patients experienced locoregional treatment failure and subsequently underwent radical nephrectomy. Two patients were diagnosed with metastatic renal cell carcinoma during follow-up. Six patients died during the follow-up period, five from unrelated causes and one from metastatic RCC. Overall survival was 80%, and RCC-specific survival was 96%.
Conclusions: This study demonstrates low recurrence rates of renal cell carcinoma following thermal ablation. In combination with previously published data, it supports the effectiveness of thermal ablation as a primary therapeutic option for a very specific patient population with small renal masses and significant comorbidities.

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