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Renal Ablation

  • Nicos Fotiadis
Chapter
Part of the Techniques in Interventional Radiology book series (TECHRAD)

Abstract

The incidence of kidney cancer is increasing steadily in the last three decades, with an estimated 60,920 new cases diagnosed in the United States in 2011. The majority of these tumors are small (≤4 cm), organ-confined, and detected incidentally at cross-sectional imaging. The current standard of care for clinically localized renal-cell carcinoma (RCC) is surgical, preferably with nephron-sparing surgery (NSS) because of the reported excellent oncologic outcome and overall survival (OS). Image-guided ablative techniques, mainly radiofrequency ablation (RFA) and cryoablation, are being used with increased frequency and excellent results in the management of small renal tumors.

  • The ideal renal tumor for the percutaneous approach is small (<3 cm), partially exophytic, and posteriorly located in a patient who cannot tolerate a partial nephrectomy.

  • Percutaneous RFA is a faster and less-expensive procedure than percutaneous cryoablation. Cryoablation is potentially more effective in central and larger lesions.

  • Hydrodissection and pyeloperfusion techniques could prevent injuries to the adjacent organs and the collecting system.

  • Close follow-up is required, with low threshold for re-intervention.

Keywords

Partial Nephrectomy Renal Mass Ablation Zone Percutaneous Cryoablation Small Renal Tumor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Reading

  1. Fotiadis NI, Sabharwal T, Morales JP, et al. Combined percutaneous radiofrequency ablation and ethanol injection of renal tumours: midterm results. Eur Urol. 2007;52(3):777–84.PubMedCrossRefGoogle Scholar
  2. Gervais DA, McGovern FJ, Arelano RS, McDougal WS, Mueller PR. Radiofrequency ablation of renal cell carcinoma, part I. Indications, results and role in patient management over a six-year period and ablation of 100 tumours. AJR Am J Roentgenol. 2005;185:64–71.PubMedGoogle Scholar
  3. Knuckle DA, Egleton BL, Uzzo RG. Excise, ablate or observe: the small renal mass dilemma – a meta-analysis and review. J Urol. 2008;179:1227–34.CrossRefGoogle Scholar
  4. Rosenberg MD, Kim CY, Tsivian M, et al. Percutaneous cryoablation of renal lesions with radiographic ice ball involvement of the renal sinus: analysis of hemorrhagic and collecting system complications. AJR Am J Roentgenol. 2011;196(4):935–9.PubMedCrossRefGoogle Scholar
  5. Van Poppel H, Becker F, Caddedu JA, et al. Treatment of localized renal cell carcinoma. Eur Urol. 2011;60(4):662–72.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  1. 1.Department of Interventional OncologyThe Royal Marsden NHS Foundation TrustLondonUK
  2. 2.Department of Interventional RadiologySt Bartholomew’s & The Royal London HospitalsLondonUK

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