Pushpender Gupta MBBS, Presenter: Nothing to Disclose

David Dixon Childs MD, Abstract Co-Author: Nothing to Disclose

Gopi Kota MBBS, Abstract Co-Author: Nothing to Disclose

Ronald Jay Zagoria MD, Abstract Co-Author: Grant, Covidien AG

To evaluate the complication rate and effect on renal function when using radiofrequency ablation (RFA) for treatment of multifocal renal neoplasms.

This IRB-approved study reviewed all patients treated with RFA for multifocal renal neoplasms. The rate and severity of complications was tabulated. Renal function (serum creatinine (sCr) and eGFR) was measured before RFA, 1 – 6 months after each RFA session, and at the last follow-up visit which was more than 6 months after the last RFA session, for evaluation of short and long-term effects on renal function. Other potential factors that could contribute to changes in renal function were recorded. Renal function results following RFA were compared to recently published results for partial nephrectomies.

24 patients, ages 39 – 88 years (mean = 73 years) had ablation of 85 renal neoplasms during 47 RFA sessions. 10 patients had 2 tumors, 4 patients had 3 tumors, 4 patients had 4 tumors, 2 patients had 6 tumors, 2 patients had 7 tumors and 1 patient had 8 tumors treated. The mean number of RCCs treated per session was 1.9. There was 1 serious complication (4.2 %), which required treatment. Mean follow-up after an RFA session was 3.1 years (range = 6 months to 6 years). After an RFA session there was no statistically significant (p value -0.17) change in sCr but there was a significant (p value – 0.010) decrease in eGFR (5.6) after a single RFA session. This is a decrease in eGFR by 2.6 per tumor treated per session. In 4 (15%) sessions there was more than 25% decrease in eGFR. While the mean long-term increase of 0.38 mg/dl in sCr and decrease of 12.2 in eGFR were statistically significant (p values – 0.04 and 0.01, respectively) there were numerous other potential contributing factors identified in each patient.

The risk of serious complications when using RFA to treat multiple renal tumors is low (4.2%) and is comparable to the rate reported for RFA treatment of single renal neoplasms. On average each RFA session will produce a mild, but statistically significant, decline in renal function. The mean decrease in eGFR after RFA is less than that reported for partial nephrectomies.

RFA is a good renal sparing alternative to surgery for patients with or propensity to develop multifocal renal tumors. Compared to patients with single tumors, the complication rate is not increased.

Gupta, P, Childs, D, Kota, G, Zagoria, R, Radiofrequency Ablation for Multifocal Renal Neoplasms: Safety and Effect on Renal Function.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9001548.html