Marco Allasia1, Francesco Soria2, Antonino Battaglia2, Carlo Gazzera3, Marco Calandri3, Mirko Parasiliti Caprino4, Barbara Lucatello4, Andrea Velrti5, Mario Maccario4, Barbara Pasini6, Andrea Bosio2, Paolo Gontero2, Paolo Destefanis2. 1. Division of Urology, Department of Surgical Science, A. O. Città della Salute e Della Scienza di Torino-presidio Molinette, University of Turin, Turin, Italy. Electronic address: marc.allasia@gmail.com. 2. Division of Urology, Department of Surgical Science, A. O. Città della Salute e Della Scienza di Torino-presidio Molinette, University of Turin, Turin, Italy. 3. Department of Interventional Radiology and Diagnostic Imaging, A. O. Città della Salute e Della Scienza di Torino-presidio Molinette, University of Turin, Turin, Italy. 4. Division of Endocrinology, Diabetology, and Metabolism, A. O. Città della Salute e Della Scienza di Torino-presidio Molinette, University of Turin, Turin, Italy. 5. Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Orbassano, Torino, Italy. 6. Department of Preventive and Predictive Medicine, Unit of Medical Genetics, A. O. Città della Salute e Della Scienza di Torino-presidio Molinette, University of Turin, Turin, Italy.
Abstract
INTRODUCTION: Management of renal-cell carcinoma (RCC) in patients with Von Hippel-Lindau syndrome (VHL) represents a clinical dilemma: the oncologic outcomes must be weighed against preservation of renal function. Radiofrequency ablation (RFA) is currently used in selected cases for treatment of small-size RCC. The aim of this study was to evaluate the safety, complications, and functional and oncologic outcomes of RFA in the treatment of RCC in VHL patients. PATIENTS AND METHODS: RCCs were treated with ultrasound-guided RFA or with laparoscopic RFA. Clinical and radiologic response, disease recurrence, and survival outcomes were evaluated during follow-up. Early and late complications were recorded and graded. RESULTS: Nine RCC patients underwent RFA. The median number of RCCs per patient was 3 (interquartile range, 2-4). Among these 9 patients, a total of 20 RCCs were treated by RFA (19 ultrasound-guided RFA and 1 laparoscopic procedure). Median RCC size was 2.5 cm (interquartile range, 2.0-3.0). RFA did not impair renal function (P = .35). In 2 cases disease persisted, and in 1 case disease recurred after 18 months. These patients were retreated with ultrasound-guided RFA with complete response and no renal function impairment. RFA treatment was overall well tolerated and safe. No complications were recorded. Postoperative stay was no longer than 1 day. CONCLUSION: RCC occurred in about two-thirds of VHL patients, who had young age at presentation; it was frequently multifocal and recurrent. The use of RFA, with extended indications, could represent a tailored treatment for VHL patients, reducing the risk of renal failure and resulting in satisfying oncologic results.
INTRODUCTION: Management of renal-cell carcinoma (RCC) in patients with Von Hippel-Lindau syndrome (VHL) represents a clinical dilemma: the oncologic outcomes must be weighed against preservation of renal function. Radiofrequency ablation (RFA) is currently used in selected cases for treatment of small-size RCC. The aim of this study was to evaluate the safety, complications, and functional and oncologic outcomes of RFA in the treatment of RCC in VHLpatients. PATIENTS AND METHODS: RCCs were treated with ultrasound-guided RFA or with laparoscopic RFA. Clinical and radiologic response, disease recurrence, and survival outcomes were evaluated during follow-up. Early and late complications were recorded and graded. RESULTS: Nine RCCpatients underwent RFA. The median number of RCCs per patient was 3 (interquartile range, 2-4). Among these 9 patients, a total of 20 RCCs were treated by RFA (19 ultrasound-guided RFA and 1 laparoscopic procedure). Median RCC size was 2.5 cm (interquartile range, 2.0-3.0). RFA did not impair renal function (P = .35). In 2 cases disease persisted, and in 1 case disease recurred after 18 months. These patients were retreated with ultrasound-guided RFA with complete response and no renal function impairment. RFA treatment was overall well tolerated and safe. No complications were recorded. Postoperative stay was no longer than 1 day. CONCLUSION:RCC occurred in about two-thirds of VHLpatients, who had young age at presentation; it was frequently multifocal and recurrent. The use of RFA, with extended indications, could represent a tailored treatment for VHLpatients, reducing the risk of renal failure and resulting in satisfying oncologic results.
Authors: Sven Gläsker; Evelynn Vergauwen; Christian A Koch; Alexander Kutikov; Alexander O Vortmeyer Journal: Onco Targets Ther Date: 2020-06-16 Impact factor: 4.147
Authors: Helen Ng; Vinson Wai-Shun Chan; Jon Cartledge; Michael Kimuli; Christy Ralph; Satinder Jagdev; Naveen Vasudev; Selina Bhattarai; James Lenton; Jonathan Smith; Tze Min Wah Journal: Radiol Case Rep Date: 2021-06-08