Percutaneous image-guided radiofrequency ablation of renal malignancies.

There is a growing body of experience supporting the use of image-guided RFA for the treatment of primary RCC. Because surgical resection is a technique with low mortality, and a proved success rate that is high, this must remain standard therapy for patients with potentially curable RCC. Some patients with low-stage RCC, however, may not be surgical candidates. Image-guided RFA is an option for treatment of these patients. In addition, image-guided RFA shows promise for the successful care of other patients with RCC. In particular, RFA has been used successfully for the treatment of intractable hematuria resulting from an RCC; local recurrences of RCC, both for attempted cure and for palliation of symptoms; and finally for the treatment of isolated metastases from RCC. As with the treatment of primary RCC, the data remain limited for these applications. This technique should be reserved until after standard therapies have been exhausted. It seems likely that some form of image-guided percutaneous tumor therapy, such as RFA, will become an alternative treatment modality in some patients with potentially curable RCC.