RFA - Radio Frequency Ablation blijkt goed alternatief als een gewone operatie van nierkankertumoren niet kan worden uitgevoerd

RFA - Radio Frequency Ablation - bij solide nierkankertumoren lijkt een goed alternatief als er niet geopereerd kan worden. zoals ook eerdere studies - zie ook op deze pagina - hebben laten zien. Zie onderstaande kleine studie bij 8 nierkankerpatiënten.

Percutaneous Radiofrequency Ablation May Be an Option for Solid Renal Masses

NEW YORK (Reuters Health) Apr 21 - In patients with solid renal masses for whom surgery is contraindicated, percutaneous radiofrequency ablation seems to be a safe alternative therapy, according to a report in the April issue of the American Journal of Roentgenology.

"Incidental small renal-cell masses are often seen in elderly patients with significant comorbidity who are unfit to undergo surgery," Dr. David J. Breen, of University Hospitals NHS Trust, Southampton, UK, and colleagues note. Such masses are almost always renal cell cancers, they add.

The researchers prospectively examined the safety and efficacy of percutaneous image-guided radiofrequency ablation in the treatment of small solid renal masses.

They performed fourteen 12-minute treatment sessions on eleven masses in eight patients, who ranged in age from 60 to 88 years. The procedure was tolerated well by all subjects, and all were ready for discharge the next day.

Computed tomography was performed 3 days after treatment. Results of the scans showed complete ablation of 9 of the 11 masses, with no residual enhancement. Two of the lesions showed some enhancement of residual tumor. These masses were treated at a later date under computed tomography guidance. None of the masses required more than two sessions.

"In four lesions, an area of increased density representing hemorrhage and necrosis was seen on the enhanced scan after radiofrequency ablation," Dr. Breen and colleagues report. "One patient had an intrarenal vessel coursing along the margin of the ablated lesion that remained unchanged on follow-up imaging."

No evidence of recurrence was observed in seven of the eight patients.

"In the era of nephron-sparing surgery," the investigators write, "radiofrequency ablation may have a role in the management of small problematic renal masses."

Am J Roentgenol 2003;180:1055-1061.