Minimal-invasive Therapie des Nierenkrebs: die perkutane Radiofrequenzablation

Zusammenfassung

In den letzten Jahren wird ein Anstieg der Inzidenz des Nierenzellkarzinoms verzeichnet, der vorwiegend auf die zunehmende Anzahl zufällig entdeckter kleiner Tumoren zurückzuführen ist. Die perkutane Radiofrequenzablation (RFA) ist ein minimal-invasives thermoablatives Verfahren zur Tumortherapie, das besonders zur Therapie kleiner renaler Tumoren geeignet ist. Als minimal-invasive Methode bietet die RFA eine geringere Patientenmorbidität und eine Reduktion der Kosten im Gesundheitswesen durch verkürzte Krankenhausaufenthalte. Bei der RFA werden ein bis drei RF-Applikatoren im Tumor platziert, durch das Anliegen eines Hochfrequenz-Wellenfeldes wird thermale Energie in diesen Tumor eingebracht. Es kommt zur irreversiblen thermischen Zerstörung der Tumorzellen. In zahlreichen Studien konnte gezeigt werden, dass die RFA ein sicheres und effektives Verfahren zur lokalen Destruktion von Nierenzellkarzinomen kleiner 5 cm darstellt.

Summary

The incidence of renal cell carcinoma is rising with an incidence of 150,000 cases per anno. Diagnosis of renal cell carcinoma is made earlier mostly because of incidental diagnostic during ultrasound, computer- or magnet-resonance tomography. Further, renal cell carcinoma often occurs in advanced age, with patients being poor candidates for surgical resection or even nephrectomy. During the past few years, percutaneous imaging-guided radiofrequency ablation has evolved as a minimally-invasive treatment alternative of small renal tumours offering not only reduced patient morbidity but also overall health-care costs. During radiofrequency ablation, thermal energy is applicated into tumor tissue by means of a needle-like applicator just under local anesthesia. Some patients can be even ambulatory treated on out-patient basis. In several recent studies and in metaanalysis, percutaneous radiofrequency ablation has been shown to be an effective and safe modality for local destruction of renal cell carcinoma up to 5 cm. Overall complication rates are lower compared with partial or total nephrectomy. Altogether, radiofrequency ablation is a new modality for the minimally-invasive treatment of renal cell carcinoma, which was demonstrated to exhibit high term effectiveness.

Schlüsselwörter

Nierenzellkarzinom - Radiofrequenzablation - minimal-invasive Therapie

Keywords

renal cell carcinoma - radiofrequency ablation - minimally-invasive treatment

Literatur

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