Percutaneous Image-guided Radiofrequency Ablation of Renal Neoplasms: Seven-year Local Experience

Full Article

WK Tsang, SF Lee, HY Cheung, PY Lui, KY Tam

Hong Kong J Radiol 2013;16:17-26

DOI: 10.12809/hkjr1312136

Objective: To evaluate the safety and efficacy of image-guided radiofrequency ablation of renal neoplasms in our centre in Hong Kong.

Methods:Records of all patients who underwent this procedure in our centre from February 2004 to March 2011 were retrospectively reviewed. The indications for non-surgical treatment, individual tumour characteristics, procedural details, complications, and follow-up results were evaluated.

Results:Over the study period, seven renal tumours from seven patients were treated with radiofrequency ablation. The most common reasons for non-surgical treatment were comorbidities and anticoagulant-related bleeding diatheses. All the patients were male, and had a mean age of 70 (standard deviation, 10.6) years. Six tumours from six patients were included under the intention-to-cure group; five tumours in this group were small (≤3 cm) and exophytic, while one was large (>3 cm) and parenchymal. One patient with bilateral renal cell carcinomas was included for palliation of haematuria. His 11-cm locally advanced left renal cell carcinoma was ablated. In total, 10 sessions of radiofrequency ablation were performed. Four patients had a single ablation session and three underwent two ablation sessions. Technical success without major complication was achieved in all sessions. There was complete tumour eradication in the entire intention-to-cure group after one (n=4) to two (n=2) ablation sessions. In the patient receiving palliation, radiofrequency ablation transiently aborted his disabling haematuria.

Conclusions:Percutaneous image-guided radiofrequency ablation can be a safe and highly effective treatment for small renal tumours in favourable positions. This technique could be regarded as a nephron-sparing treatment for non-surgical candidates. It also has a role in palliation of metastatic or locally advanced disease.







結果:研究期間共7名腎腫瘤患者(7例)接受射頻消融術。進行非手術治療的最普遍原因為患者有 並存病以及因機體抗凝引致的出血傾向。所有病人均為男性,平均年齡70歲(標準差10.6歲)。6名 患者(6例)屬意向治癒組,其中5名患者有小腫瘤(即3 cm或以下)並屬外生性,另1名患者有大腫 瘤(即3 cm以上)並屬實性。1名有雙側腎細胞癌的病人為緩解血尿症狀而被納入舒緩治療組,對其 局部晚期的左腎細胞癌(11 cm)進行消融術。總計操作完成了10次射頻消融術。4名患者接受單次 的消融術,另3名患者接受兩次的消融術。在研究期間各消融術均達至技術性成功並沒有嚴重的併發 症。意向治癒組中分別接受單次消融術(4例)及兩次消融術(2例)的6名病人的腫瘤均得以治癒。 另1名接受舒緩治療的患者,其持暫性的血尿均能在每次射頻消融後的1個月內完全停止。

結論:對於體積小並處於優勢位置的腎腫瘤,經皮穿刺影像引導下射頻消融治療不但安全,而且高 度有效。對選擇非手術方法的患者來說,射頻消融可視作一種腎單位保留術。而對於腫瘤轉移或有 局部進展的患者來說,射頻消融有緩解的作用。