Effectiveness and safety of computed tomography-guided radiofrequency ablation of renal cancer: a 14-year single institution experience in 203 patients

To define effectiveness and safety of CT-guided radiofrequency ablation (RFA) of renal tumours and prognostic indicators for treatment success. Patients with a single treatment of a solitary, biopsy-proven renal tumour with intent to cure over a 14-year period were included (n = 203). Probability of residual disease over time, complication rates and all-cause mortality were assessed in relation to multiple variables. Mean tumour size was 2.5 cm (range 1.0-6.0). Mean follow-up was 34.1 months (range 1-131). There was an increase in likelihood of residual disease for tumours a parts per thousand yen3.5 cm (P < 0.05), clear cell subtype of renal cell carcinoma (P a parts per thousand currency signaEuro parts per thousand 0.005) and maximum treatment temperature a parts per thousand currency sign70 A degrees C (P < 0.05). There was a decrease in likelihood of residual disease for exophytic tumours (P = 0.01) and no difference based on age, gender, tumour location or type of radio freqency (RF) electrode used. Major complications occurred in 3.9 %. Median post-treatment survival was 7 years for patients with tumours < 4 cm, and 5-year overall survival was 80 %. Probability of minor complication increased with tumour size (P = 0.03), as did all-cause mortality (P = 0.005). CT-guided RFA is safe and effective for early-stage renal cancer, particularly for exophytic tumours measuring < 3.5 cm. Overall 5-year survival with tumours < 4 cm is comparable to partial nephrectomy. aEuro cent Prognostic indicators for success of CT-guided RFA of renal tumours are reported. aEuro cent Tumour size a parts per thousand yen3.5 cm confers an increased risk for residual tumour. aEuro cent Clear cell renal cell carcinoma subtype confers increased risk for residual tumour. aEuro cent Tmax < 70 A degrees C within the ablation zone confers increased risk for residual tumour. aEuro cent Exophytic tumours have a lower probability of residual disease.