Abstract

Background. For many patients, open complete or partial nephrectomy, or laparoscopic nephrectomy remains the treatment of choice for kidney tumours. However, some patients, who are poor surgical candidates or have limited life expectancy, could benefit  from an effective minimally invasive procedure. In addition, a nonsurgical option could also benefit patients with hereditary predisposition to renal cell carcinoma, such as patients with von Hippel-Lindau disease.
The aim of this study was to evaluate the technical efficacy and feasibility of minimally invasive image guided radiofrequency ablation (RFA) for treatment of small peripheral and central renal tumours in North Estonian Medical Centre from June 2006 to February 2007.
Material and methods. Seven RFA sessions for 7 tumours were performed in 6 patients with renal masses. The main indications were previous partial or complete nephrectomy and high surgical or anaesthetic risk. All tumours were imaged before RF ablation with contrastenhanced computed tomography (CT). The diagnosis of a tumour was based on enlarged enhancing renal mass at CT. Three tumours were ablated under CT guidance and 4 under ultrasound guidance. Mean patients’ age was 69 years. Mean tumour size was 2.4 cm.
Results. Technical success was defined as elimination of the areas that enhanced at imaging within the entire tumour. All tumours were successfully ablated with one session using additional overlapping ablations. Five patients of the 6 had no substantial flank pain at rest, 2 had pain during 12 hours after ablation haematuria that did not require treatment. The mean follow-up time without tumour recurrences was 3 months.
Conclusion / Discussion. Our early experience with percutaneous image-guided radiofrequency ablation demonstrates that this minimally invasive procedure is safe, feasible, and effective for treatment of small peripheral and central renal tumours. As many small Renal Cell Carcinomas (RCC) grow at a rate of 1–3 mm per year, longer-term follow-up to assess local recurrence or metastatic disease is needed.