Analysis of Radiofrequency Ablation of Small Renal Tumors in Patients at High Anesthetic and Surgical Risk: Urologist Experience with Follow-up Results in the Initial Six Months

Background: To evaluate the results of various types of radiofrequency ablation (RFA) treatment of renaltumors in patients with excessive anesthetic and surgical risk. Materials and
Methods: Data for RFA performedin in high risk patients were retrospectively evaluated. Other RFA applications in patients with no anestheticand/or surgical risk were excluded. RFA was by ultrasound or CT guided percutaneous (USG/CT-PRFA) andretroperitoneally or transperitoneally laparoscopic (R/T-LRFA) techniques under general or local anethesia.Follow-up data of enhanced CT or MRI after 1, 3 and 6 months were analysed for twelve RFA applications.
Results: The RFA applications included 4 (40%) left-sided, 5 (50%) right-sided and 1 (10%) bilaterally RFA(simultaneously 1 right and 2 left). The localizations of tumors were 2 (16.6%) upper, 5 (41.6%) mid and 5(41.6%) lower pole. The RFA applications included 9 (75%) USG-PRFA, 1 (8.3%) CT-PRFA, 1 (8.3%) T-LRFAand 1 (8.3%) R-LRFA. The mean age was 65.3±8.5 (52-76) years. The mean tumor size was 29.6±6.08 (15-40)mm. No complications related to the RFA were encountered in any of the cases. Failure (residual tumour) wasdetermined in 8.3% (1/12) of USG-RFA application. The success rate was thus 91.7% (11/12). Other 1st, 3rd and6th months follow-up data revealed no residua and recurrence.
Conclusions: RFA application appears to be safeas a less invasive and effective treatment modality in selected cases of small renal tumors in individuals withexcessive anesthetic and also surgical risk.