Surena F Matin1, Kamran Ahrar. 1. Department of Urology, The University of Texas, M.D. Anderson Cancer Center, Houston, Texas, USA. surmatin@mdanderson.org
Abstract
PURPOSE OF REVIEW: Cryoablation and radiofrequency ablation are the two most utilized forms of ablative therapy, and the most mature. Recent follow-up studies have been published that further highlight their possible roles as relevant treatment options for select patients with renal cell carcinoma. RECENT FINDINGS: Three- and five-year outcomes following cryoablation and radiofrequency ablation have recently been published, respectively, each showing 93-98% cancer-specific survival in small cohorts. Several other single-institution series have been published showing favorable outcomes based on imaging findings alone, albeit with much shorter follow-up times. These findings are mitigated by the probability that some of the treated small tumors may have been benign and those that were malignant may have been indolent. SUMMARY: The longest-term outcomes of probe-ablative therapy with cryoablation and radiofrequency ablation suggest satisfactory outcomes by imaging when careful patient selection and rigorous attention to technical details are utilized. Imaging findings alone usually provide the only surrogate measure of success. Given the limitations of current imaging techniques and the indolent growth rate of many of these tumors, however, continued stringent selection criteria and rigorous follow-up of all patients undergoing ablative therapy is required.
PURPOSE OF REVIEW: Cryoablation and radiofrequency ablation are the two most utilized forms of ablative therapy, and the most mature. Recent follow-up studies have been published that further highlight their possible roles as relevant treatment options for select patients with renal cell carcinoma. RECENT FINDINGS: Three- and five-year outcomes following cryoablation and radiofrequency ablation have recently been published, respectively, each showing 93-98% cancer-specific survival in small cohorts. Several other single-institution series have been published showing favorable outcomes based on imaging findings alone, albeit with much shorter follow-up times. These findings are mitigated by the probability that some of the treated small tumors may have been benign and those that were malignant may have been indolent. SUMMARY: The longest-term outcomes of probe-ablative therapy with cryoablation and radiofrequency ablation suggest satisfactory outcomes by imaging when careful patient selection and rigorous attention to technical details are utilized. Imaging findings alone usually provide the only surrogate measure of success. Given the limitations of current imaging techniques and the indolent growth rate of many of these tumors, however, continued stringent selection criteria and rigorous follow-up of all patients undergoing ablative therapy is required.
Authors: Lin Li; Wei Ling Lau; Connie M Rhee; Kevin Harley; Csaba P Kovesdy; John J Sim; Steve Jacobsen; Anthony Chang; Jaime Landman; Kamyar Kalantar-Zadeh Journal: Nat Rev Nephrol Date: 2014-01-14 Impact factor: 28.314