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| Radiofrequency ablation for renal tumours: A retrospective study from a tertiary centre |
Mohammed Al-Zubaidia,*( ),Kennia Lottera,Martin Marshallb,Mikhail Lozinskiya
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aDepartment of Urology, Royal Perth Hospital, Perth, Australia
bDepartment of Radiology, Royal Perth Hospital, Perth, Australia |
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Abstract Objective: This study aimed to evaluate the safety and efficacy outcomes of percutaneous radiofrequency ablation (RFA) for localised renal cell carcinoma (RCC) in a tertiary hospital patient who remained unfit for surgical intervention.
Methods: We retrospectively analysed survival outcomes for patients with biopsy proven RCC treated by RFA at Royal Perth Hospital between September 2009 and May 2018. Complication data were gathered for all patients that underwent renal RFA along with 2- and 5-year recurrence-free survival (RFS) rate and compared the outcomes with data from previous studies.
Results: A total of 69 patients (73 procedures) were eligible for the study, and those patients had biopsy-proven RCC with a minimum of 2-year follow-up. The complication rate was 8.2% (6/73) and local recurrence rate 9.6% (7/73). Two-year RFS is 95.7% and 5-year RFS is 78.8% on a median 3.82-year follow-up (interquartile range 1.90-5.75 years).
Conclusion: RFA performed at our centre was found to be safe and effective with low complication rates and durable RFS in line with expectations from existing research. Our study demonstrated that RFA is an alternative modality of treatment for small renal tumours in patients unfit for surgical approach.
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Received: 17 November 2020
Available online: 20 April 2023
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Corresponding Authors:
Mohammed Al-Zubaidi
E-mail: mohammed_az1985@yahoo.com
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| Patients details | Value | | Number of patients, n (%) | 69 (100) | | Male | 41 (59.4) | | Female | 28 (40.6) | | Age, median (range), year | 68 (47-89) | | Median follow-up period, year | 6 |
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Patient demographics.
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| Tumour characteristic | Value | | Size, median (range), cm | 3.2 (1.2-5.2) | | Size, n (%) | | ≤4 cm | 69 (94.5) | | >4 cm | 4 (5.5) | | Tumour location, n (%) | | Left side | 41 (56.2) | | Right side | 31 (42.5) | | Pelvic kidney | 1 (1.4) | | Location in affected kidney, n (%) | | Upper pole | 13 (17.8) | | Interpolar | 33 (45.2) | | Lower pole | 27 (37.0) |
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The cohort tumour characteristics (n=73).
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| Reason | Value, n (%) | | Comorbidities increasing the risk of surgery and/or anaesthesia | 48 (65.8) | | Solitary kidney | 5 (6.8) | | Recurrence | 4 (5.5) | | Patient preference | 16 (21.9) | | Multiple tumours same kidney | 1 (1.4) |
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Indications for choosing percutaneous radiofrequency ablation over surgical approach.
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| Complication | Value, n (%) | | Haematoma | 4 (5.5) | | Contrast extravasation | 1 (1.4) | | Pneumothorax | 1 (1.4) | | Total | 6 (8.2) |
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Radiofrequency ablation complication in our cohort.
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| Patient number | Tumour size prior to first RFA, mm | Tumour size upon recurrence, mm | Modality of treatment | Interval | Histology | | 1 | 20 | 20 | RFA | 2 years | Clear cell RCC | | 2 | 30 | 22 | RFA | 4 months | Clear cell RCC | | 3 | 33 | 21 | RFA | 4 years | Clear cell RCC | | 4 | 38 | 42 | RFA | 2 years | Clear cell RCC | | 5 | 16 | 20 | Partial nephrectomy | 6 months | Clear cell RCC | | 6 | 21 | 17 | Radical nephrectomy | 3 years | Clear cell RCC | | 7 | 30 | 15 | Partial nephrectomy | 13 months | Clear cell RCC |
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Recurrent renal tumour after the first ablation details.
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