Greater Renal Tumor Enhancement Is a Risk Factor for Radiofrequency Ablation

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Degree of tumor enhancement should be considered when counseling patients prior to radiofrequency ablation for malignant renal tumors.
Degree of tumor enhancement should be considered when counseling patients prior to radiofrequency ablation for malignant renal tumors.

Degree of tumor enhancement should be considered when counseling patients prior to radiofrequency ablation (RFA) for malignant renal tumors.1

Investigators conducted a retrospective review of patient who underwent RFA for renal tumors and had contrast enhanced imaging performed. They calculated the change in Hounsfield units between the time from non-contrast phase to contrast-enhanced arterial phase in order to determine if greater tumor enhancement was a risk factor for RFA failure due to increased vascularity.

A total of 99 patients with biopsy confirmed malignant renal tumors and contrast-enhance imaging were included in the study. Results showed that the incomplete ablation rate was significantly less for tumors that enhanced < 60 HU vs ≥ 60 HU. Multivariate logistic regression analysis confirmed those results (OR, 1.14; P = .008).

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Patients whose tumors were smaller than 3 cm had better 5-year disease-free survival (100% vs 69.2%, respectively; P < .01). Five-year disease-free survival for patients whose tumors had HU changes < 60 was 100% compared with 92.4% for patients who had an HU chance ≥ 60.

“Biopsy confirmed malignant renal tumors, which exhibit a change in enhancement ≥ 60 HU, experience a higher rate of incomplete initial tumor ablation than tumors < 60 HU,” the authors concluded.

Reference

  1. Lay AH, Stewart J, Canvasser NE, et al. Likelihood of incomplete kidney tumor ablation with radiofrequency energy: degree of enhancement matters [article in press]. J Urol. doi: 10.1016/j.juro.2016.01.099.

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