Radiofrequency thermoablation (RFA) in kidney cancer patients

Abstract

The aim: to evaluate the own direct results of the RFA of kidney tumors in A.V. Vishnevsky National Medical Research Center of Surgery.Materials and methods. The study included the results of examination and treatment of 22 patients with kidney tumors treated at A.V. Vishnevsky National Medical Center of Surgery (16 men and 6 women aged 40 to 81, mean age 61.5 years). All patients underwent preoperative ultrasound, MSCT with contrast enhancement., Patients underwent RFA of kidney tumors using the Radionics Cool-Tip ® Ablation System (USA) at various stages of treatment In the postoperative period, all patients underwent MSCT monitoring with contrast enhancement and ultrasound with duplex scanning, as well as ultrasound with contrast enhancement – in 7 patients and MRI with contrast enhancement on the first day after the intervention – in 5 patients. Dynamic follow-up was performed in the postoperative period from 3 to 60 months (median 17.8 months).Results. Depending on the surgical tactics, the patients were divided into two groups: the first (16 patients) – RFA was performed as the first independent stage of treatment; the second (6 patients) – RFA was performed as a staged treatment for kidney resection.The tumor was solitary in 19 patients of both groups, multiple – in 3. In tumors of the first group, with sizes exceeding 30.0 mm in diameter, a positive effect was obtained from the manipulation: no progression of the tumor was detected during dynamic observation. These patients underwent 2 to 3 RFA sessions. In tumors of the second group, the size did not exceed 30.0 mm, 2 to 4 sessions (on average 3 sessions) of RFA were performed, which was due to multiple lesions in 3 cases.The use of RFA in the treatment of patients with small kidney cancer in patients with concomitant diseases that do not allow for radical treatment, made it possible to obtain a relapse-free period of an average of 16.5 months. The use of RFA, as a stage in the treatment of primary multiple kidney cancer, showed a relapse-free period of an average of 21.2 months.Conclusion. The use of radiofrequency ablation in the treatment of kidney cancer patients can significantly expand the scope of surgical care, both in the case of patients with concomitant diseases that do not allow a significant amount of surgical intervention, and in the treatment of patients with primary multiple cancer of both kidneys as a stage treatment.