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Review
. 2022 Aug 15;9(3):5-23.
doi: 10.15586/jkcvhl.v9i3.233. eCollection 2022.

Modern Management of Localized Renal Cell Carcinoma- Is Ablation Part of the Equation?

Zev Leopold  1 , Rachel Passarelli  1 , Mark Mikhail  1 , Alexandra Tabakin  1 , Kevin Chua  1 , Ronald D Ennis  2 , John Nosher  3 , Eric A Singer  1
Affiliations
Review

Modern Management of Localized Renal Cell Carcinoma- Is Ablation Part of the Equation?

Zev Leopold et al. J Kidney Cancer VHL. .

Abstract

While the gold-standard for management of localized renal cell carcinoma (RCC) is partial nephrectomy, recent ablative strategies are emerging as alternatives with comparable rates of complications and oncologic outcomes. Thermal ablation, in the form of radiofrequency ablation and cryoablation, is being increasingly accepted by professional societies, and is particularly recommended in patients with a significant comorbidity burden, renal impairment, old age, or in those unwilling to undergo surgery. Maturation of long-term oncologic outcomes has further allowed increased confidence in these management strategies. New and exciting ablation technologies such as microwave ablation, stereotactic body radiotherapy, and irreversible electroporation are emerging. In this article, we review the existing management options for localized RCC, with specific focus on the oncologic outcomes associated with the various ablation modalities.

Keywords: cryoablation; microwave ablation; percutaneous ablation; radiofrequency ablation; renal cell carcinoma; stereotactic ablative body radiotherapy.

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Conflict of interest statement

The authors declare no potential conflicts of interest with respect to research, authorship, and/or publication of this article.

Figures

Figure 1:
Figure 1:
(A) Ice ball seen on the end of cryoablation probe. (B) Ice ball seen in renal tumor during cryoablation. (C) Depiction of isotherms of ice ball.
Figure 2:
Figure 2:
Depiction of radiofrequency causing ionic agitation and subsequent frictional heating.
Figure 3:
Figure 3:
(A) Multi-tined radiofrequency ablation antenna. (B) Radiofrequency ablation antenna expanded within tumor. (C) Typical tissue changes after successful radiofrequency ablation including pseudo-capsule, subcapsular fat, and nonenhancing lesion.
Figure 4:
Figure 4:
(A) Microwave antenna seen in 3 cm, upper pole renal mass. (B) Follow-up at 3 months shows residual enhancement of the superior aspect of the lesion consistent with residual tumor, demonstrating the importance of follow-up.
Figure 5:
Figure 5:
Depiction of microwave antenna generating a field of heat.
Figure S1:
Figure S1:
PubMed Search Query.
See this image and copyright information in PMC

References

    1. Turner RM 2nd, Morgan TM, Jacobs BL. Epidemiology of the small renal mass and the treatment disconnect phenomenon. Urol Clin North Am. 2017;44(2):147–54. 10.1016/j.ucl.2016.12.001 - DOI - PMC - PubMed
    1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7–33. 10.3322/caac.21708 - DOI - PubMed
    1. Sanchez A, Feldman AS, Hakimi AA. Current management of small renal masses, including patient selection, renal tumor biopsy, active surveillance, and thermala. J Clin Oncol. 2018;36(36):3591–600. 10.1200/JCO.2018.79.2341 - DOI - PMC - PubMed
    1. Dai JC, Morgan TN, Moody D, McLaughlin J, Cadeddu JA. Radiofrequency ablation of small renal masses. J Endourol. 2021;35(S2):S38–S45. 10.1089/end.2020.1041 - DOI - PubMed
    1. Chandrasekar T, Boorjian SA, Capitanio U, Gershman B, Mir MC, Kutikov A. Collaborative review: Factors influencing treatment decisions for patients with a localized solid renal mass. Eur Urol. 2021;80(5):575–88. 10.1016/j.eururo.2021.01.021 - DOI - PubMed

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