Radio frequency ablation shows promise as treatment for small renal tumors

מתוך medicontext.co.il
NEW YORK (Reuters Health) – Percutaneous radio frequency ablation appears to be an effective, well-tolerated treatment for renal tumors 3 cm or less in diameter, according to preliminary trial results published in the January issue of The Journal of Urology.

Many reports document the use of radio frequency ablation for liver tumors, but relatively few investigators have applied the therapy to renal tumors. A minimally invasive means of tumor destruction could be particularly useful in managing patients prone to recurrent renal tumors, such as those with von Hippel-Lindau disease.

Dr. Christian P. Pavlovich and colleagues, from the National Cancer Institute in Bethesda, Maryland, assessed the value of percutaneous radio frequency ablation in 21 patients with renal tumors. All of the tumors were 3 cm or less on CT and had demonstrated growth.

A total of 24 ablations were performed and all but 2 were done under conscious sedation, the investigators note. From baseline to 2 months after ablation, the mean tumor diameter decreased from 2.4 to 2.0 cm (p = 0.001). Furthermore, 19 of the 24 tumors ceased to enhance on contrast CT. No worsening of serum creatinine levels was noted.

While no major complications occurred, two patients experienced transient psoas pain and two experienced flank skin numbness, the researchers state.

The natural history of radio frequency-ablated tumors and the predictors of success with this form of therapy remain to be determined. "If long-term results are favorable, radio frequency ablation should prove to be an attractive option for small renal masses in patients at risk for multiple renal tumors or with other relative contraindications to surgery," Dr. Pavlovich's team concludes.

In a related editorial, Dr. Andrew C. Novick, from the Cleveland Clinic Foundation in Ohio, emphasizes that before any new nephron-sparing treatment can be incorporated into routine clinical practice, the success rates must be proven comparable to those of partial nephrectomy.

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