Ablative Therapies for Small Renal Tumours

Overview

Journal Nat Rev Urol

Specialty Urology

Date 2013 Apr 24

PMID 23609841

Citations 10

Authors

Arturo Castro Jr

Lawrence C Jenkins

Nelson Salas

Gideon Lorber

Raymond J Leveillee

Affiliations

Soon will be listed here.

Abstract

Improvements in imaging technology have resulted in an increase in detection of small renal masses (SRMs). Minimally invasive ablation modalities, including cryoablation, radiofrequencey ablation, microwave ablation and irreversible electroporation, are currently being used to treat SRMs in select groups of patients. Cryoablation and radiofrequency ablation have been extensively studied. Presently, cryoablation is gaining popularity because the resulting ice ball can be visualized easily using ultrasonography. Tumour size and location are strong predictors of outcome of radiofrequency ablation. One of the main benefits of microwave ablation is that microwaves can propagate through all types of tissue, including desiccated and charred tissue, as well as water vapour, which might be formed during the ablation. Irreversible electroporation has been shown in animal studies to affect only the cell membrane of undesirable target tissues and to spare adjacent structures; however, clinical studies that depict the efficacy and safety of this treatment modality in humans are still sparse. As more experience is gained in the future, ablation modalities might be utilized in all patients with tumours <4 cm in diameter, rather than just as an alternative treatment for high-risk surgical patients.

Citing Articles

A Comparison of Functional and Oncologic Outcomes between Partial Nephrectomy and Radiofrequency Ablation in Patients with Chronic Kidney Disease after Propensity Score Matching.

Ryoo H, Kang M, Sung H, Jeon H, Jeong B, Jeon S Diagnostics (Basel). 2022; 12(10).

PMID: 36291981 PMC: 9600482. DOI: 10.3390/diagnostics12102292.

Percutaneous radiofrequency ablation on a Xp11.2 Translocation Renal Cell Carcinoma: A case report.

Kanas A, Rovella M, de Moura M, Leite K, Srougi M, de Menezes M Urol Case Rep. 2020; 33:101401.

PMID: 33102099 PMC: 7574040. DOI: 10.1016/j.eucr.2020.101401.

Long-term renal function following zero ischemia partial nephrectomy.

Boga M, Sonmez M Res Rep Urol. 2019; 11:43-52.

PMID: 30881944 PMC: 6404680. DOI: 10.2147/RRU.S174996.

Expanding thermal ablation to the 'intermediate-sized' renal mass: clinical utility in T1b tumors.

Schulman A, Tay K, Polascik T Transl Androl Urol. 2017; 6(1):127-130.

PMID: 28217461 PMC: 5313302. DOI: 10.21037/tau.2017.01.08.

Multipoint Thermal Sensors Associated with Improved Oncologic Outcomes Following Cryoablation.

Martin J, Patel R, Okhunov Z, Vyas A, Vajgrt D, Clayman R J Endourol. 2017; 31(4):355-360.

PMID: 28114787 PMC: 5397231. DOI: 10.1089/end.2016.0864.

References

Bhowmick S, Coad J, Swanlund D, Bischof J . In vitro thermal therapy of AT-1 Dunning prostate tumours. Int J Hyperthermia. 2003; 20(1):73-92. DOI: 10.1080/0265673031000111932. View

Rodriguez R, Cizman Z, Hong K, Koliatsos A, Georgiades C . Prospective analysis of the safety and efficacy of percutaneous cryoablation for pT1NxMx biopsy-proven renal cell carcinoma. Cardiovasc Intervent Radiol. 2010; 34(3):573-8. DOI: 10.1007/s00270-010-9934-7. View

Hope W, Schmelzer T, Newcomb W, Heath J, Lincourt A, Norton H . Guidelines for power and time variables for microwave ablation in an in vivo porcine kidney. J Surg Res. 2008; 153(2):263-7. DOI: 10.1016/j.jss.2008.03.044. View

Gervais D, Arellano R, Mueller P . Percutaneous ablation of kidney tumors in nonsurgical candidates. Oncology (Williston Park). 2005; 19(11 Suppl 4):6-11. View

Guazzoni G, Cestari A, Buffi N, Lughezzani G, Nava L, Cardone G . Oncologic results of laparoscopic renal cryoablation for clinical T1a tumors: 8 years of experience in a single institution. Urology. 2010; 76(3):624-9. DOI: 10.1016/j.urology.2010.03.078. View

Leveillee R, Castle S, Gorbatiy V, Salas N, Narayanan G, Morillo-Burgos G . Oncologic outcomes using real-time peripheral thermometry-guided radiofrequency ablation of small renal masses. J Endourol. 2012; 27(4):480-9. DOI: 10.1089/end.2012.0305. View

Rioja J, Tzortzis V, Mamoulakis C, Laguna M . [Cryotherapy for renal tumors: current status and contemporary developments]. Actas Urol Esp. 2010; 34(4):309-17. View

Kang D, Palmer D, Zarei M, Shah P, Folsom C, Beyth R . A systematic review of the quality of evidence of ablative therapy for small renal masses. J Urol. 2011; 187(1):44-7. DOI: 10.1016/j.juro.2011.09.046. View

Ritchie R, Leslie T, Phillips R, Wu F, Illing R, Ter Haar G . Extracorporeal high intensity focused ultrasound for renal tumours: a 3-year follow-up. BJU Int. 2010; 106(7):1004-9. DOI: 10.1111/j.1464-410X.2010.09289.x. View

10.

Schmit G, Atwell T, Leibovich B, Callstrom M, Kurup A, Woodrum D . Percutaneous cryoablation of anterior renal masses: technique, efficacy, and safety. AJR Am J Roentgenol. 2010; 195(6):1418-22. DOI: 10.2214/AJR.09.3530. View

11.

Bird V, Carey R, Ayyathurai R, Bird V . Management of renal masses with laparoscopic-guided radiofrequency ablation versus laparoscopic partial nephrectomy. J Endourol. 2009; 23(1):81-8. DOI: 10.1089/end.2008.0087. View

12.

Ji C, Li X, Zhang S, Gan W, Zhang G, Zeng L . Laparoscopic radiofrequency ablation of renal tumors: 32-month mean follow-up results of 106 patients. Urology. 2011; 77(4):798-802. DOI: 10.1016/j.urology.2010.10.014. View

13.

Salas N, Ramanathan R, Dummett S, Leveillee R . Results of radiofrequency kidney tumor ablation: renal function preservation and oncologic efficacy. World J Urol. 2010; 28(5):583-91. DOI: 10.1007/s00345-010-0562-2. View

14.

Carrafiello G, Lagana D, Ianniello A, Mangini M, Fontana F, Cotta E . Percutaneous radiofrequency thermal ablation of renal cell carcinoma: is it possible a day-hospital treatment?. Int J Surg. 2009; 6 Suppl 1:S31-5. DOI: 10.1016/j.ijsu.2008.12.034. View

15.

Gettman M, Lotan Y, Lindberg G, Napper C, Hoopman J, Pearle M . Laparoscopic interstitial laser coagulation of renal tissue with and without hilar occlusion in the porcine model. J Endourol. 2002; 16(8):565-70. DOI: 10.1089/089277902320913242. View

16.

Marberger M, Schatzl G, Cranston D, Kennedy J . Extracorporeal ablation of renal tumours with high-intensity focused ultrasound. BJU Int. 2005; 95 Suppl 2:52-5. DOI: 10.1111/j.1464-410X.2005.05200.x. View

17.

Rewcastle J, Sandison G, Saliken J, Donnelly B, McKinnon J . Considerations during clinical operation of two commercially available cryomachines. J Surg Oncol. 1999; 71(2):106-11. DOI: 10.1002/(sici)1096-9098(199906)71:2<106::aid-jso9>3.0.co;2-z. View

18.

Guan W, Bai J, Liu J, Wang S, Zhuang Q, Ye Z . Microwave ablation versus partial nephrectomy for small renal tumors: intermediate-term results. J Surg Oncol. 2012; 106(3):316-21. DOI: 10.1002/jso.23071. View

19.

Gupta A, Raman J, Leveillee R, Wingo M, Zeltser I, Lotan Y . General anesthesia and contrast-enhanced computed tomography to optimize renal percutaneous radiofrequency ablation: multi-institutional intermediate-term results. J Endourol. 2009; 23(7):1099-105. DOI: 10.1089/end.2008.0499. View

20.

Faddegon S, Cadeddu J . Does renal mass ablation provide adequate long-term oncologic control?. Urol Clin North Am. 2012; 39(2):181-90, vi. DOI: 10.1016/j.ucl.2012.01.004. View