O Heißler1, S Seklehner2,3, H Fellner4, P F Engelhardt2,3, A Chemelli4, C Riedl2. 1. Abteilung für Urologie, Landesklinikum Baden, Waltersdorfer Str. 75, 2500, Baden, Österreich. ortwin.heissler@baden.lknoe.at. 2. Abteilung für Urologie, Landesklinikum Baden, Waltersdorfer Str. 75, 2500, Baden, Österreich. 3. Paracelsus Medizinische Privatuniversität, Salzburg, Österreich. 4. Abteilung für Radiologie, Landesklinikum Baden, Baden, Österreich.
Abstract
BACKGROUND: The incidence of small renal masses has increased in recent decades. Standard surgical treatment may not be applicable in patients with advanced age or severe comorbidities. Therefore, minimally invasive therapeutic approaches, such as radiofrequency ablation (RFA), may be a therapeutic option for such patients. OBJECTIVES: Assessment of oncological and functional outcomes of percutaneous RFA in small renal masses. MATERIALS AND METHODS: Single center evaluation of all RFA performed at the hospital Landesklinikum Baden from 2006-2016. RESULTS: A total of 98 RFA were performed in 85 patients. Mean patient age was 69.5 years. Median tumor size was 26.2 mm, while the length of hospital stay was 1.4 days. Overall, 96.8% of RFA procedures were considered to be technically complete. Recurrence rate was 17.5%. Most of the recurrences were treated via a second RFA. Complication rates were fairly low as the vast majority of ablations were free of complications (82.7%). Grade I, II and III complications (according to the Clavien-Dindo classification) occurred in 13.3%, 3% and 1%, respectively. A significant deterioration of renal function due to RFA was not observed. Cancer-specific survival rate for renal cell carcinoma was 100%; overall survival was 84.7% after an average follow-up period of more than 3 years. CONCLUSION: RFA is an adequate alternative treatment option for small renal masses in patients unfit to undergo surgical excision. Patients benefit from the low complication rates, preservation of renal function, and short hospital stays.
BACKGROUND: The incidence of small renal masses has increased in recent decades. Standard surgical treatment may not be applicable in patients with advanced age or severe comorbidities. Therefore, minimally invasive therapeutic approaches, such as radiofrequency ablation (RFA), may be a therapeutic option for such patients. OBJECTIVES: Assessment of oncological and functional outcomes of percutaneous RFA in small renal masses. MATERIALS AND METHODS: Single center evaluation of all RFA performed at the hospital Landesklinikum Baden from 2006-2016. RESULTS: A total of 98 RFA were performed in 85 patients. Mean patient age was 69.5 years. Median tumor size was 26.2 mm, while the length of hospital stay was 1.4 days. Overall, 96.8% of RFA procedures were considered to be technically complete. Recurrence rate was 17.5%. Most of the recurrences were treated via a second RFA. Complication rates were fairly low as the vast majority of ablations were free of complications (82.7%). Grade I, II and III complications (according to the Clavien-Dindo classification) occurred in 13.3%, 3% and 1%, respectively. A significant deterioration of renal function due to RFA was not observed. Cancer-specific survival rate for renal cell carcinoma was 100%; overall survival was 84.7% after an average follow-up period of more than 3 years. CONCLUSION: RFA is an adequate alternative treatment option for small renal masses in patients unfit to undergo surgical excision. Patients benefit from the low complication rates, preservation of renal function, and short hospital stays.
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