Radiofrequency Ablation of Metastases from Renal Cell Carcinoma: Technique, Complications, and Midterm Outcome

ObjectivesTo determine the therapeutic effect of radiofrequency ablation of metastases from renal cell carcinoma (RCC) with respect to complications and local tumor control.MethodsSixty-six radiofrequency ablations under computed tomography (CT) fluoroscopy control were performed in 38 patients with metastatic RCC. The ablation was performed for local tumor volume reduction in 7 patients and for complete local tumor control in 31 patients. Sites of ablation included the liver (39), lung (11), kidney (11), adrenal glands (2), and lymph nodes or soft tissue (3). CT scanning was performed immediately after the ablation procedure and at 3, 6, 12,18, and 24 mo during the follow-up period. Size of the target lesion, ablation duration and temperature, and complications associated with the ablation procedure and rate of local recurrence were recorded.ResultsAt a mean follow-up of 10 mo (median: 12 mo; range: 3–47 mo), no complications were observed except two pneumothoraces that did not require further intervention. The average metastasis size was 7.9 cm in patients treated for volume reduction and 2.3 cm in patients treated for local tumor control. One local recurrence in the kidney, caused by incorrect needle placement during the ablation procedure, was detected on the first imaging control. The average ablation duration per metastasis was 11.5 min; a mean temperature of 70.5 °C was reached in the target lesion.ConclusionsPercutaneous radiofrequency ablation represents a safe treatment technique for metastases from RCC. Indications in selected patients may be both tumor volume reduction and complete ablation of the metastatic site.