Document Detail


Sequential combination treatment (arterial embolization and percutaneous radiofrequency ablation) of inoperable renal cell carcinoma: single-center pilot study.
MedLine Citation:
PMID:  22393159     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BackgroundPotential drawbacks of percutaneous radiofrequency ablation (RFA) for renal cell carcinoma (RCC) include local recurrence after RFA due to a limited ablation area, massive hemorrhage induced by kidney puncture, and difficulty in visualizing the tumor at CT-guided puncture.PurposeTo evaluate retrospectively the technical success, effectiveness, and complications elicited in patients with unresectable RCC following single-session sequential combination treatment consisting of renal arterial embolization followed by RFA.Material and MethodsTen patients (12 RCCs) who were not candidates for surgery were included in this pilot study. All tumors ranged from 18-66 mm in size (mean 31 ± 3.9 mm), and were percutaneously ablated several hours after embolization of the tumor vessels with iodized oil and gelatin sponges. We evaluated the technical success, effectiveness, effect on renal function, and complications of this treatment. Effectiveness was judged on CT and/or MR images obtained every three months after RFA. The effect on renal function was assessed based on the creatinine level and glomerular filtration rate (GFR) before, one week, and three months after the procedure.ResultsRenal arterial embolization followed by percutaneous RFA was technically successful in all patients. On contrast CT and/or MR images obtained one week and three months after RFA we observed necrosis in the embolized segment of all RCCs. There were no major complications during and after the procedure. All patients reported tolerable pain and a burning sensation during RFA. After the procedure, five patients (50%) experienced back pain, one each manifested fluid collection, subcapsular hematomas, hematuria, or nausea. There were no instances of recurrence during a mean follow-up period of 47 ± 3.8 months. We noted no significant difference in serum creatinine and GFR before and after treatment.ConclusionOur pilot study suggests that sequential combination treatment by renal arterial embolization followed by percutaneous RFA is feasible in patients with inoperable RCC. The treatment complications were acceptable and excellent effects were obtained.
Authors:
Yutaka Nakasone; Koichi Kawanaka; Osamu Ikeda; Yoshitaka Tamura; Yasuyuki Yamashita
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-5
Journal Detail:
Title:  Acta radiologica (Stockholm, Sweden : 1987)     Volume:  -     ISSN:  1600-0455     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706123     Medline TA:  Acta Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, Honjo Kumamoto, Japan.
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