Introduction: Thermal ablation (TA) is increasingly used as a treatment for localized renal masses (LRMs, <4 cm) especially in older or comorbid patients. Our previous article by Mershon et al., highlighted the safety and efficacy of TA for treatment of LRMs in select patients. In this presentation, we update that work and discuss new frontiers for TA including patient selection, procedural improvements, and outcomes.
Evidence acquisition: A structured literature review was conducted on PubMed using the keywords: “renal cell carcinoma,” “renal mass,” and “ablation” as well as “complication,” “renal function,” “outcomes”, “cost”, “solitary kidney”, “propensity score” and/or “partial nephrectomy”. Additional papers were cross referenced via citation review.
Evidence synthesis: TA is technically suited for small and less complex tumors in older patients or patients with multiple comorbidities especially chronic kidney disease, solitary kidney or multiple renal masses. Percutaneous technique allows for decreased length of stay and faster recovery time due to the minimally invasive nature of TA. No prospective or randomized trials to compare TA to partial nephrectomy. Comparative studies demonstrate lower complication rates, preservation of renal function, and similar cancer specific survival when compared to partial nephrectomy.
Conclusions: TA is a safe and effective management option for SRM in select patients especially older patients with multiple other co-morbidities.
Carcinoma, Renal cell, Ablation techniques, Radiofrequency ablation, Cryosurgery, Microwaves