Percutaneous radiofrequency ablation of renal tumors in solitary kidney patients.

OBJECTIVES: In solitary kidney patients with renal cell carcinoma (RCC), radiofrequency ablation (RFA) could be effective in achieving complete tumor necrosis without increasing the risk of complications or renal failure. To analyze the outcomes of a group of solitary kidney patients treated for RCC by RFA considering tumor size and location, renal function involvement and complications. METHODS: A transversal retrospective study was performed, in which we selected 11 solitary kidney patients with 19 tumors in total treated by RFA for one or more renal tumors. A CT protocol was used for follow up. It included unenhanced series and contrast enhanced series at 1 month, 3-6 months, 12 months and yearly after RFA. Serum creatinine levels of each patient, pre RFA and within the first 48 hours after RFA, were collected. RESULTS: Complete ablation was achieved in 17 tumors (89.4%) after one or two RFA sessions. 100% of exophytic and parenchymal tumors, and 3 cm size or smaller, were completely ablated. Renal failure, immediate complications or more than 24 hours hospitalization were not observed in 10 (90.1%) of our patients. CONCLUSIONS: RFA treatment for RCC in solitary kidney patients has a high success rate; it does not affect renal function and achieves complete initial tumor necrosis, especially in exophytic, parenchymal and 3 cm or smaller lesions.

Ablación percutánea por radiofrecuencia de tumores renales en pacientes monorrenos / Percutaneous radiofrequency ablation of renal tumors in solitary kidney patients

OBJETIVO: En los pacientes monorrenos (PMR) con carcinoma de células renales (CCR), en los que existe la necesidad de conservar la función renal, la ablación por radiofrecuencia (ARF) podría ser efectiva para conseguir la necrosis total del tumor, sin incrementar el riesgo de complicaciones y fallo renal. Objetivo: analizar la evolución de un grupo de PMR a quienes se les realizó ARF considerando la localización y tamaño de las lesiones, la posible afectación de la función renal y la ocurrencia de complicaciones.MÉTODOS: En el presente estudio transversal y retrospectivo, 11 PMR, con un total de 19 tumores, sometidos a ARF como tratamiento de uno o varios tumores, fueron seleccionados para un seguimiento y control evolutivo de las lesiones mediante TC sin y con contraste realizados en los meses 1, 6 y 12 post-tratamiento con ARF. Igualmente se obtuvieron los niveles de creatinina en cada paciente pretratamiento y en las primeras 48h post ARF.RESULTADOS: La ARF consiguió ablación total en 17 tumores (89,4%), tras una o dos sesiones de tratamiento. El 100% de los tumores de localización exofítica y parenquimatosa y/o con un tamaño menor a 3cm fueron completamente necrosados. En 10 pacientes (90,1%) no se observó compromiso de la función renal y/o complicación inmediata u hospitalización superior a las 24 h post-tratamiento con ARF.CONCLUSIONES: La ARF en PMR, tiene una elevada tasa de éxito sin comprometer la función renal y permitiendo la necrosis total inicial del CCR, especialmente en lesiones pequeñas y de localización exofítica o parenquimatosa(AU)

OBJECTIVES: In solitary kidney patients with renal cell carcinoma (RCC), radiofrequency ablation (RFA) could be effective in achieving complete tumor necrosis without increasing the risk of complications or renal failure.To analyze the outcomes of a group of solitary kidney patients treated for RCC by RFA considering tumor size and location, renal function involvement and complications. METHODS: A transversal retrospective study was performed, in which we selected 11 solitary kidney patients with 19 tumors in total treated by RFA for one or more renal tumors. A CT protocol was used for follow up. It included unenhanced series and contrast enhanced series at 1 month, 3-6 months, 12 months and yearly after RFA. Serum creatinine levels of each patient, pre RFA and within the first 48 hours after RFA, were collected.RESULTS: Complete ablation was achieved in 17 tumors (89.4%) after one or two RFA sessions. 100% of exophytic and parenchymal tumors, and 3 cm size or smaller, were completely ablated. Renal failure, immediate complications or more than 24 hours hospitalization were not observed in 10 (90.1%) of our patients.CONCLUSIONS: RFA treatment for RCC in solitary kidney patients has a high success rate; it does not affect renal function and achieves complete initial tumor necrosis, especially in exophytic, parenchymal and 3 cm or smaller lesions(AU)