Long-Term Survival after Percutaneous Radiofrequency Ablation of Pathologically Proven Renal Cell Carcinoma in 100 Patients

Marshall, Harry R. et al.
Journal of Vascular and Interventional Radiology, Volume 31, Issue 1, 15 – 24
DOI: 10.1016/j.jvir.2019.09.011

Abstract

Purpose

To determine the long-term survival of patients treated with percutaneous radiofrequency (RF) ablation for pathologically proven renal cell carcinoma (RCC).

Materials and Methods

In this single-center retrospective study, 100 patients with 125 RCCs (100 clear-cell, 19 papillary, and 6 chromophobe) 0.8–8 cm in size treated with RF ablation were evaluated at a single large tertiary-care center between 2004 and 2015. Technical success, primary and secondary technique efficacy, and pre- and postprocedural estimated glomerular filtration rate (eGFR) at 3–6 months and 2–3 years were recorded. Overall survival, cancer-specific survival, and local tumor progression–free survival were calculated by Kaplan–Meier survival curves. Complications were classified per the Clavien–Dindo system. Statistical testing was done via χ2tests for proportions and paired t test for changes in eGFR. Statistical significance was set at α = 0.05.

Results

Overall technical success rate was 100%, and primary and secondary technique efficacy rates were 90% and 100%, respectively. Median follow-up was 62.8 months, ranging from 1 to 120 months. The 10-year overall, cancer-specific, and local progression–free survival rates were 32%, 86%, and 92%, respectively. The number of ablation probes used was predictive of residual unablated tumor (P < .001). There were no significant changes in preprocedure vs 2–3-years postprocedure eGFR (65.2 vs 62.1 mL/min/1.73 m2; P = .443). There was a 9% overall incidence of complications, the majority of which were grade I.

Conclusion

Image-guided percutaneous RF ablation of RCCs is effective at achieving local control and preventing cancer-specific death within 10 years from initial treatment.

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