Percutaneous ablation of renal masses measuring 3.0 cm and smaller: Comparative local control and complications after radiofrequency ablation and cryoablation

Thomas D. Atwell, Grant D. Schmit, Stephen A. Boorjian, Jay Mandrekar, A. Nicholas Kurup, Adam J. Weisbrod, George K. Chow, Bradley C. Leibovich, Matthew R. Callstrom, David E. Patterson, Christine M. Lohse, R. Houston Thompson

Research output: Contribution to journalArticle

112 Scopus citations

Abstract

OBJECTIVE. The purpose of this article is to compare the efficacy and complication rates of percutaneous radiofrequency ablation (RFA) and cryoablation in the treatment of renal masses measuring 3.0 cm and smaller. MATERIALS AND METHODS. A retrospective review was performed of 385 patients with 445 tumors measuring 3.0 cm or smaller treated with thermal ablation from 2000 through 2010. Two hundred fifty-six tumors in 222 patients were treated with RFA (mean [± SD] tumor size, 1.9 ± 0.5 cm), and 189 tumors in 163 patients were treated with cryoablation (mean tumor size, 2.3 ± 0.5 cm). Major complications and efficacy as measured by technical success and local tumor recurrence rates were recorded. RESULTS. There were five (1.1%) technical failures, including one (0.4%) among tumors treated with RFA and four (2.1%) among tumors treated with cryoablation (p = 0.17). Of the 218 tumors treated with RFA and with follow-up beyond 3 months, seven (3.2%) developed local tumor recurrence, at a mean of 2.8 years after treatment (range, 1.2-4.1 years). Of the 145 tumors treated with cryoablation and with follow-up beyond 3 months, four (2.8%) developed local tumor recurrence at a mean of 0.9 years after treatment (range, 0.3-1.6 years). For biopsy-proven renal cell carcinoma, estimated local recurrence-free survival rates at 1, 3, and 5 years after RFA were 100%, 98.1%, and 98.1%, respectively, compared with 97.3%, 90.6%, and 90.6%, respectively, after cryoablation (p = 0.09). Major complications occurred after 4.3% (10/232) of RFAs and 4.5% (8/176) of cryoablation procedures (p = 0.91). CONCLUSION. RFA and cryoablation are both effective in the treatment of renal masses measuring 3 cm or smaller. Major complications with either procedure are infrequent.

Original languageEnglish (US)
Pages (from-to)461-466
Number of pages6
JournalAmerican Journal of Roentgenology
Volume200
Issue number2
DOIs
StatePublished - Feb 1 2013

Keywords

  • Ablation
  • Complications
  • Cryoablation
  • Radiofrequency
  • Renal cell carcinoma
  • Survival

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Atwell, T. D., Schmit, G. D., Boorjian, S. A., Mandrekar, J., Kurup, A. N., Weisbrod, A. J., Chow, G. K., Leibovich, B. C., Callstrom, M. R., Patterson, D. E., Lohse, C. M., & Thompson, R. H. (2013). Percutaneous ablation of renal masses measuring 3.0 cm and smaller: Comparative local control and complications after radiofrequency ablation and cryoablation. American Journal of Roentgenology, 200(2), 461-466. https://doi.org/10.2214/AJR.12.8618