Long-term Outcomes After Percutaneous Radiofrequency Ablation for Renal Cell Carcinoma

ObjectivesTo assess the long-term oncological efficacy of radiofrequency ablation (RFA) for treatment of renal cell carcinoma (RCC).MethodsIn this institutional review board–approved, retrospective study, the records and imaging studies for all RCC patients treated with percutaneous RFA before 2005 were reviewed and analyzed.ResultsA total of 48 RCCs in 41 patients were treated with RFA. Median size of RCC treated was 2.6 cm (range: 0.7-8.2 cm). Of the 48 treated RCCs, 5 (12%) had recurrent tumor after a single ablation session. The median size of the index lesion in the cases with recurrence was 5.2 cm (interquartile range [IQR]: 4-5.3) compared with 2.2 cm (IQR: 1.7-3.1, P = .0014) without local recurrence. There were no recurrences when RCCs less than 4 cm were treated. Seventeen (41%) patients with 18 treated RCCs died during the follow-up period at a median time of 34 (IQR: 10-47) months. One patient (2%) died of metastatic RCC, whereas 16 died of unrelated causes. Twenty-four patients with 30 RCCs treated with RFA survived. For the remaining 30 RCCs, median follow up was 61 months (IQR: 54-68). No patients in this group of survivors had metastatic RCC, 1 had recurrence diagnosed at 68 months. The long-term recurrence-free survival rate was 88% after RFA.ConclusionsRFA can result in durable oncological control for RCCs less than 4 cm. RFA is an effective treatment option for patients with RCCs less than 4 cm who are poor surgical candidates. For patients with larger RCCs alternative treatments should be considered.