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Oncologic outcomes for ablative therapy of kidney cancer

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Abstract

Needle ablative therapies for small incidental renal masses are emerging as alternatives to traditional extirpative surgery. Reasons include their associated decreased morbidity, shorter convalescence, and the ability to avert the higher risk of extirpative surgery in an aging patient population. Cryoablation (CA) and radiofrequency ablation are the two most thoroughly studied needle ablative methods used for renal cancer. High-intensity focused ultrasound has also been studied but with limited published human experience at this time. For both radiofrequency ablation and CA, in vitro experiments, animal studies, and (increasingly) human experience have been published, allowing us to define appropriate candidates for such therapies, their oncologic outcomes, and the potential pitfalls. While long-term data is being collected, the current literature suggests that CA and radiofrequency ablation can be safely performed and can effectively eradicate small renal cancers with cancer-specific survival rates similar to those of traditional surgical options.

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References and Recommended Reading

  1. Fergany AF, Hafez KS, Novick AC: Long-term results of nephron sparing surgery for localized renal cell carcinoma: 10-year followup. J Urol 2000, 163:442–445.

    Article  PubMed  CAS  Google Scholar 

  2. Pasticier G, Timsit MO, Badet L, et al.: Nephron-sparing surgery for renal cell carcinoma: detailed analysis of complications over a 15-year period. Eur Urol 2006, 49:485–490.

    Article  PubMed  CAS  Google Scholar 

  3. Matin SF, Gill IS, Worley S, Novick AC: Outcome of laparoscopic radical and open partial nephrectomy for the sporadic 4 cm. or less renal tumor with a normal contralateral kidney. J Urol 2002, 168:1356–1359.

    Article  PubMed  Google Scholar 

  4. Ramani AP, Desai MM, Steinberg AP, et al.: Complications of laparoscopic partial nephrectomy in 200 cases. J Urol 2005, 173:42–47.

    Article  PubMed  Google Scholar 

  5. Gupta A, Allaf ME, Kavoussi LR, et al.: Computerized tomography guided percutaneous renal cryoablation with the patient under conscious sedation: initial clinical experience. J Urol 2006, 175:447–452.

    Article  PubMed  Google Scholar 

  6. Allaf ME, Varkarakis IM, Bhayani SB, et al.: Pain control requirements for percutaneous ablation of renal tumors: cryoablation versus radiofrequency ablation—initial observations. Radiology 2005, 237:366–370.

    Article  PubMed  Google Scholar 

  7. Luciani LG, Cestari R, Tallarigo C: Incidental renal cell carcinoma-age and stage characterization and clinical implications: study of 1092 patients (1982–1997). Urology 2000, 56:58–62.

    Article  PubMed  CAS  Google Scholar 

  8. Larson TR, Robertson DW, Corica A, Bostwick DG: In vivo interstitial temperature mapping of the human prostate during cryosurgery with correlation to histopathologic outcomes. Urology 2000, 55:547–552.

    Article  PubMed  CAS  Google Scholar 

  9. Rehman J, Landman J, Lee D, et al.: Needle-based ablation of renal parenchyma using microwave, cryoablation, impedance-and temperature-based monopolar and bipolar radiofrequency, and liquid and gel chemoablation: laboratory studies and review of the literature. J Endourol 2004, 18:83–104.

    Article  PubMed  Google Scholar 

  10. Campbell SC, Krishnamurthi V, Chow G, et al.: Renal cryosurgery: experimental evaluation of treatment parameters. Urology 1998, 52:29–33.

    Article  PubMed  CAS  Google Scholar 

  11. Shingleton WB, Sewell PE JR: Percutaneous renal tumor cryoablation with magnetic resonance imaging guidance. J Urol 2001, 165:773–776.

    Article  PubMed  CAS  Google Scholar 

  12. Bolte SL, Ankem MK, Moon TD, et al.: Magnetic resonance imaging findings after laparoscopic renal cryoablation. Urology 2006, 67:485–489.

    Article  PubMed  Google Scholar 

  13. Nadler RB, Kim SC, Rubenstein JN, et al.: Laparoscopic renal cryosurgery: the Northwestern experience. J Urol 2003, 170:1121–1125.

    Article  PubMed  Google Scholar 

  14. Gill IS, Remer EM, Hasan WA, et al.: Renal cryoablation: outcome at 3 years. J Urol 2005, 173:1903–1907.

    Article  PubMed  Google Scholar 

  15. Bhowmick P, Coad JE, Bhowmick S, et al.: In vitro assessment of the efficacy of thermal therapy in human benign prostatic hyperplasia. Int J Hyperthermia 2004, 20:421–439.

    Article  PubMed  CAS  Google Scholar 

  16. Matsumoto ED, Watumull L, Johnson DB, et al.: The radiographic evolution of radio frequency ablated renal tumors. J Urol 2004, 172:45–48.

    Article  PubMed  Google Scholar 

  17. Merkle EM, Nour SG, Lewin JS: MR imaging follow-up after percutaneous radiofrequency ablation of renal cell carcinoma: findings in 18 patients during first 6 months. Radiology 2005, 235:1065–1071.

    Article  PubMed  Google Scholar 

  18. Sackett DL, Rosenberg WM, Gray JA, et al.: Evidence based medicine: what it is and what it isn’t. BMJ 1996, 312:71–72.

    PubMed  CAS  Google Scholar 

  19. Chaussy C, Thuroff S, Rebillard X, Gelet A: Technology insight: High-intensity focused ultrasound for urologic cancers. Nat Clin Pract Urol 2005, 2:191–198.

    Article  PubMed  Google Scholar 

  20. Vaezy S, Shi X, Martin RW, et al.: Real-time visualization of high-intensity focused ultrasound treatment using ultrasound imaging. Ultrasound Med Biol 2001, 27:33–42.

    Article  PubMed  CAS  Google Scholar 

  21. Damianou C, Pavlou M, Velev O, Kyriakou K, et al.: High intensity focused ultrasound ablation of kidney guided by MRI. Ultrasound Med Biol 2004, 30:397–404.

    Article  PubMed  Google Scholar 

  22. Chapelon JY, Margonari J, Theillere Y, et al.: Effects of high-energy focused ultrasound on kidney tissue in the rat and the dog. Eur Urol 1992, 22:147–152.

    PubMed  CAS  Google Scholar 

  23. Chavrier F, Chapelon JY, Gelet A, Cathignol D: Modeling of high-intensity focused ultrasound-induced lesions in the presence of cavitation bubbles. J Acoust Soc Am 2000, 108:432–440.

    Article  PubMed  Google Scholar 

  24. Susani M, Madersbacher S, Kratzik C, et al.: Morphology of tissue destruction induced by focused ultrasound. Eur Urol 1993, 23(Suppl 1):34–38.

    PubMed  Google Scholar 

  25. Vallancien G, Chartier-Kastler E, Harouni M, et al.: Focused extracorporeal pyrotherapy: experimental study and feasibility in man. Semin Urol 1993, 11:7–9.

    PubMed  CAS  Google Scholar 

  26. Marberger M, Schatzl G, Cranston D, Kennedy JE: Extracorporeal ablation of renal tumours with high-intensity focused ultrasound. BJU Int 2005, 95(Suppl 2):52–55.

    Article  PubMed  Google Scholar 

  27. Illing RO, Kennedy JE, Wu F, et al.: The safety and feasibility of extracorporeal high-intensity focused ultrasound (HIFU) for the treatment of liver and kidney tumours in a Western population. Br J Cancer 2005, 93:890–895.

    Article  PubMed  CAS  Google Scholar 

  28. Wu F, Wang ZB, Chen WZ, et al.: Preliminary experience using high intensity focused ultrasound for the treatment of patients with advanced stage renal malignancy. J Urol 2003, 170:2237–2240.

    Article  PubMed  Google Scholar 

  29. Rukstalis DB, Khorsandi M, Garcia FU, et al.: Clinical experience with open renal cryoablation. Urology 2001, 57:34–39.

    Article  PubMed  CAS  Google Scholar 

  30. Bassignani MJ, Moore Y, Watson L, Theodorescu D: Pilot experience with real-time ultrasound guided percutaneous renalmass cryoablation. J Urol 2004, 171:1620–1623.

    Article  PubMed  Google Scholar 

  31. Silverman SG, Tuncali K, Vansonnenberg E, et al.: Renal tumors: MR imaging-guided percutaneous cryotherapy—initial experience in 23 patients. Radiology 2005, 236:716–724.

    Article  PubMed  Google Scholar 

  32. Lawatsch EJ, Langenstroer P, Byrd GF, et al.: Intermediate results of laparoscopic cryoablation in 59 patients at the Medical College of Wisconsin. J Urol 2006, 175:1225–1229.

    Article  PubMed  Google Scholar 

  33. Lee DI, Mcginnis DE, Feld R, Strup SE: Retroperitoneal laparoscopic cryoablation of small renal tumors; intermediate results. Urology 2003, 61:83–88.

    Article  PubMed  Google Scholar 

  34. Moon TD, Lee FT JR, Hedican SP, et al.: Laparoscopic cryoablation under sonographic guidance for the treatment of small renal tumors. J Endourol 2004, 18:436–440.

    Article  PubMed  Google Scholar 

  35. Cestari A, Guazzoni G, dell’Acqua V, et al.: Laparoscopic cryoablation of solid renal masses: intermediate term followup. J Urol 2004, 172:1267–1270.

    Article  PubMed  Google Scholar 

  36. Bachmann A, Sulser T, Jayet C, et al.: Retroperitoneoscopy-assisted cryoablation of renal tumors using multiple 1.5 mm ultrathin cryoprobes: a preliminary report. Eur Urol 2005, 47:474–479.

    Article  PubMed  Google Scholar 

  37. McDougal WS, Gervais DA, Mcgovern FJ, Mueller PR: Long-term followup of patients with renal cell carcinoma treated with radio frequency ablation with curative intent. J Urol 2005, 174:61–63.

    Article  PubMed  Google Scholar 

  38. Mayo-Smith WW, Dupuy DE, Parikh PM, et al.: Imaging-guided percutaneous radiofrequency ablation of solid renal masses: techniques and outcomes of 38 treatment sessions in 32 consecutive patients. AJR Am J Roentgenol 2003, 180:1503–1508.

    PubMed  Google Scholar 

  39. Farrell MA, Charboneau WJ, Dimarco DS, et al.: Imaging-guided radiofrequency ablation of solid renal tumors. AJR Am J Roentgenol 2003, 180:1509–1513.

    PubMed  CAS  Google Scholar 

  40. Zagoria RJ, Hawkins AD, Clark PE, et al.: Percutaneous CT-guided radiofrequency ablation of renal neoplasms: factors influencing success. AJR Am J Roentgenol 2004, 183:201–207.

    PubMed  Google Scholar 

  41. Hwang JJ, Walther MM, Pautler SE, et al.: Radio frequency ablation of small renal tumors:: intermediate results. J Urol 2004, 171:1814–1818.

    Article  PubMed  CAS  Google Scholar 

  42. Lewin JS, Nour SG, Connell CF, et al.: Phase II clinical trial of interactive MR imaging-guided interstitial radiofrequency thermal ablation of primary kidney tumors: initial experience. Radiology 2004, 232:835–845.

    Article  PubMed  Google Scholar 

  43. Park S, Anderson JK, Matsumoto ED, et al.: Radiofrequency of Renal Tumors: Intermediate term results. J Endourol 2006, 20:569–573.

    Article  PubMed  Google Scholar 

  44. Varkarakis IM, Allaf ME, Inagaki T, et al.: Percutaneous radio frequency ablation of renal masses: results at a 2-year mean followup. J Urol 2005, 174:456–460.

    Article  PubMed  Google Scholar 

  45. Sabharwal R, Vladica P: Renal tumors: technical success and early clinical experience with radiofrequency ablation of 18 tumors. Cardiovasc Intervent Radiol 2006, 29:202–209.

    Article  PubMed  Google Scholar 

  46. Memarsadeghi M, Schmook T, Remzi M, et al.: Percutaneous radiofrequency ablation of renal tumors: Midterm results in 16 patients. Eur J Radiol 2006, 59:183–189.

    Article  PubMed  Google Scholar 

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Correspondence to W. Bruce Shingleton MD.

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Park, S., Cadeddu, J.A. & Shingleton, W.B. Oncologic outcomes for ablative therapy of kidney cancer. Curr Urol Rep 8, 31–37 (2007). https://doi.org/10.1007/s11934-007-0018-4

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