Download PDF
Semin intervent Radiol 2011; 28(4): 361-366
DOI: 10.1055/s-0031-1296078
© Thieme Medical Publishers

Thermoablation of Renal Masses: The Urologist's Perspective

Phillip H. Abbosh1 , Sam B. Bhayani1
  • 1Division of Urology, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
Further Information

Publication History

Publication Date:
03 January 2012 (online)

Also available at
    Permissions and Reprints

ABSTRACT

Thermoablation (TA) has become an increasingly popular treatment for small renal masses (SRMs). Although long-term outcomes are not currently reported, TA may have a role in being an alternative to radical or partial nephrectomy. This review gives a broad overview of TA and discusses current controversies in the field.

KEYWORDS

Ablation - thermoablation - renal malignancy - renal cell carcinoma - interventional radiology

REFERENCES

  • 1 Jayson M, Sanders H. Increased incidence of serendipitously discovered renal cell carcinoma.  Urology. 1998;  51 (2) 203-205
    Google Scholar
  • 2 Mathew A, Devesa S S, Fraumeni Jr J F, Chow W H. Global increases in kidney cancer incidence, 1973–1992.  Eur J Cancer Prev. 2002;  11 (2) 171-178
    Google Scholar
  • 3 Campbell S C, Novick A C, Belldegrun A Practice Guidelines Committee of the American Urological Association et al. Guideline for management of the clinical T1 renal mass.  J Urol. 2009;  182 (4) 1271-1279
    Google Scholar
  • 4 Mues A C, Haramis G, Badani K et al.. Active surveillance for larger (cT1bN0M0 and cT2N0M0) renal cortical neoplasms.  Urology. 2010;  76 (3) 620-623
    Google Scholar
  • 5 Kassouf W, Aprikian A G, Laplante M, Tanguay S. Natural history of renal masses followed expectantly.  J Urol. 2004;  171 (1) 111-113 discussion 113
    Google Scholar
  • 6 Chawla S N, Crispen P L, Hanlon A L, Greenberg R E, Chen D Y, Uzzo R G. The natural history of observed enhancing renal masses: meta-analysis and review of the world literature.  J Urol. 2006;  175 (2) 425-431
    Google Scholar
  • 7 Nguyen M M, Gill I S. Effect of renal cancer size on the prevalence of metastasis at diagnosis and mortality.  J Urol. 2009;  181 (3) 1020-1027 discussion 1027
    Google Scholar
  • 8 Matin S F, Ahrar K, Cadeddu J A et al.. Residual and recurrent disease following renal energy ablative therapy: a multi-institutional study.  J Urol. 2006;  176 (5) 1973-1977
    Google Scholar
  • 9 Zagoria R J, Hawkins A D, Clark P E et al.. Percutaneous CT-guided radiofrequency ablation of renal neoplasms: factors influencing success.  AJR Am J Roentgenol. 2004;  183 (1) 201-207
    Google Scholar
  • 10 Kunkle D A, Egleston B L, Uzzo R G. Excise, ablate or observe: the small renal mass dilemma–a meta-analysis and review.  J Urol. 2008;  179 (4) 1227-1233 discussion 1233-1224
    Google Scholar
  • 11 Beemster P, Phoa S, Wijkstra H, de la Rosette J, Laguna P. Follow-up of renal masses after cryosurgery using computed tomography; enhancement patterns and cryolesion size.  BJU Int. 2008;  101 (10) 1237-1242
    Google Scholar
  • 12 Davenport M S, Caoili E M, Cohan R H et al.. MRI and CT characteristics of successfully ablated renal masses: imaging surveillance after radiofrequency ablation.  AJR Am J Roentgenol. 2009;  192 (6) 1571-1578
    Google Scholar
  • 13 Matsumoto E D, Watumull L, Johnson D B et al.. The radiographic evolution of radio frequency ablated renal tumors.  J Urol. 2004;  172 (1) 45-48
    Google Scholar
  • 14 Remer E M, Weinberg E J, Oto A, O'Malley C M, Gill I S. MR imaging of the kidneys after laparoscopic cryoablation.  AJR Am J Roentgenol. 2000;  174 (3) 635-640
    Google Scholar
  • 15 Stein A J, Mayes J M, Mouraviev V et al.. Persistent contrast enhancement several months after laparoscopic cryoablation of the small renal mass may not indicate recurrent tumor.  J Endourol. 2008;  22 (11) 2433-2439
    Google Scholar
  • 16 Schirmang T C, Mayo-Smith W W, Dupuy D E, Beland M D, Grand D J. Kidney neoplasms: renal halo sign after percutaneous radiofrequency ablation—incidence and clinical importance in 101 consecutive patients.  Radiology. 2009;  253 (1) 263-269
    Google Scholar
  • 17 Porter C A, Woodrum D A, Callstrom M R et al.. MRI after technically successful renal cryoablation: early contrast enhancement as a common finding.  AJR Am J Roentgenol. 194 (3) 790-793
    Google Scholar
  • 18 Cestari A, Guazzoni G, dell'Acqua V et al.. Laparoscopic cryoablation of solid renal masses: intermediate term followup.  J Urol. 2004;  172 (4 Pt 1) 1267-1270
    Google Scholar
  • 19 Rendon R A, Kachura J R, Sweet J M et al.. The uncertainty of radio frequency treatment of renal cell carcinoma: findings at immediate and delayed nephrectomy.  J Urol. 2002;  167 (4) 1587-1592
    Google Scholar
  • 20 Michaels M J, Rhee H K, Mourtzinos A P, Summerhayes I C, Silverman M L, Libertino J A. Incomplete renal tumor destruction using radio frequency interstitial ablation.  J Urol. 2002;  168 (6) 2406-2409 discussion 2409-2410
    Google Scholar
  • 21 Sindelar W F, Javadpour N, Bagley D H. Histological and ultrastructural changes in rat kidney after cryosurgery.  J Surg Oncol. 1981;  18 (4) 363-379
    Google Scholar
  • 22 Chosy S G, Nakada S Y, Lee Jr F T, Warner T F. Monitoring renal cryosurgery: predictors of tissue necrosis in swine.  J Urol. 1998;  159 (4) 1370-1374
    Google Scholar
  • 23 Campbell S C, Krishnamurthi V, Chow G et al.. Renal cryosurgery: experimental evaluation of treatment parameters.  Urology. 1998;  52 (1) 29-33 discussion 33-24
    Google Scholar
  • 24 Hegarty N J, Gill I S, Desai M M, Remer E M, O'Malley C M, Kaouk J H. Probe-ablative nephron-sparing surgery: cryoablation versus radiofrequency ablation.  Urology. 2006;  68 (1, Suppl) 7-13
    Google Scholar
  • 25 Kunkle D A, Uzzo R G. Cryoablation or radiofrequency ablation of the small renal mass: a meta-analysis.  Cancer. 2008;  113 (10) 2671-2680
    Google Scholar
  • 26 Pirasteh A, Snyder L, Boncher N, Passalacqua M, Rosenblum D, Prologo J D. Cryoablation vs. radiofrequency ablation for small renal masses.  Acad Radiol. 2011;  18 (1) 97-100
    Google Scholar
  • 27 Mues A C, Okhunov Z, Haramis G et al.. Comparison of percutaneous and laparoscopic renal cryoablation for small (<3.0 cm) renal masses.  J Endourol. 24 (7) 1097-1100
    Google Scholar
  • 28 Long C J, Kutikov A, Canter D J et al.. Percutaneous vs surgical cryoablation of the small renal mass: is efficacy compromised?.  BJU Int. 2011;  107 (9) 1376-1380
    Google Scholar
  • 29 American Urological Association. Guideline for Management of the Clinical Stage 1 Renal Mass. Available at: http://www.auanet.org/content/media/renalmass09.pdf Accessed on May 2, 2011
    Google Scholar
  • 30 Sung G T, Gill I S, Hsu T H et al.. Effect of intentional cryo-injury to the renal collecting system.  J Urol. 2003;  170 (2 Pt 1) 619-622
    Google Scholar
  • 31 Brashears III J H, Raj G V, Crisci A et al.. Renal cryoablation and radio frequency ablation: an evaluation of worst case scenarios in a porcine model.  J Urol. 2005;  173 (6) 2160-2165
    Google Scholar
  • 32 Atwell T D, Farrell M A, Callstrom M R et al.. Percutaneous cryoablation of large renal masses: technical feasibility and short-term outcome.  AJR Am J Roentgenol. 2007;  188 (5) 1195-1200
    Google Scholar
  • 33 Lehman D S, Hruby G W, Phillips C K et al.. First Prize (tie): Laparoscopic renal cryoablation: efficacy and complications for larger renal masses.  J Endourol. 2008;  22 (6) 1123-1127
    Google Scholar
  • 34 Schmit G D, Atwell T D, Callstrom M R et al.. Ice ball fractures during percutaneous renal cryoablation: risk factors and potential implications.  J Vasc Interv Radiol. 2010;  21 (8) 1309-1312
    Google Scholar
  • 35 Schwartz B F, Rewcastle J C, Powell T, Whelan C, Manny Jr T, Vestal J C. Cryoablation of small peripheral renal masses: a retrospective analysis.  Urology. 2006;  68 (1, Suppl) 14-18
    Google Scholar
  • 36 Vricella G J, Haaga J R, Adler B L et al.. Percutaneous cryoablation of renal masses: impact of patient selection and treatment parameters on outcomes.  Urology. 2011;  77 (3) 649-654
    Google Scholar
  • 37 Hruby G, Edelstein A, Karpf J et al.. Risk factors associated with renal parenchymal fracture during laparoscopic cryoablation.  BJU Int. 2008;  102 (6) 723-726
    Google Scholar
  • 38 Bodily K D, Atwell T D, Mandrekar J N et al.. Hydrodisplacement in the percutaneous cryoablation of 50 renal tumors.  AJR Am J Roentgenology. 194 (3) 779-783
    Google Scholar
  • 39 DeBenedectis C M, Beland M D, Dupuy D E, Mayo-Smith W W. Utility of iodinated contrast medium in hydrodissection fluid when performing renal tumor ablation.  J Vasc Interv Radiol. 2010;  21 (5) 745-747
    Google Scholar
  • 40 Lee S J, Choyke L T, Locklin J K, Wood B J. Use of hydrodissection to prevent nerve and muscular damage during radiofrequency ablation of kidney tumors.  J Vasc Interv Radiol. 2006;  17 (12) 1967-1969
    Google Scholar
  • 41 Farrell M A, Charboneau J W, Callstrom M R, Reading C C, Engen D E, Blute M L. Paranephric water instillation: a technique to prevent bowel injury during percutaneous renal radiofrequency ablation.  AJR Am J Roentgenol. 2003;  181 (5) 1315-1317
    Google Scholar
  • 42 Ginat D T, Saad W, Davies M, Walman D, Erturk E. Bowel displacement for CT-guided tumor radiofrequency ablation: techniques and anatomic considerations.  J Endourol. 2009;  23 (8) 1259-1264
    Google Scholar
  • 43 Ginat D T, Saad W E. Bowel displacement and protection techniques during percutaneous renal tumor thermal ablation.  Tech Vasc Interv Radiol. 2010;  13 (2) 66-74
    Google Scholar

Sam B. BhayaniM.D. 

Division of Urology, Department of Surgery, Washington University School of Medicine

4960 Children's Place, St. Louis, MO 63110

Email: bhayanisa@wudosis.wustl.edu

      >