Login to Access Video or Poster Abstract: MP100-15
Sources of Funding: NONE

Introduction

Widespread availability of cross sectional abdominal imaging increased the incidence of diagnosing low stage renal mass. Radio Frequency Ablation (RFA) is a treatment option in selected patients. Long-term outcome data is limited in the literature. We present our long-term follow up data after RFA

Methods

We reviewed the IRB approved RFA database at a tertiary care center. All patients were diagnosed with renal mass by contrast enhanced CT or MRI before surgery. They underwent laparoscopic RFA or computerized tomography guided RFA between November 2001 and August 2013. Patients were followed for tumor recurrence by contrast CT or MRI at 1 month, 6 months, 1 year and annually thereafter. Demographic and oncological follow up data were analyzed.

Results

There were 398 patients underwent 466 RFA procedures for the median tumor size of 2.3cm. Their median age was 70 years (IQR 57-76), mean pre-operative creatinine was 1.13 (± 0.41) and mean creatinine during most recent follow up visit was 1.18 (± 0.49). Median follow up time was 48 months (IQR 46-150 months). Radiographic failure (enhancement in the follow up CT/MRI) was diagnosed in 38 (9.5%) patients and 31 (82%) of them had follow up biopsy. Biopsy pathology showed renal cell cancer (RCC) in 18/31 (58%) patients (11 clear cell, 2 papillary and 5 unclassified RCC) and rest had normal renal parenchyma or non-diagnostic. Another thirteen patients developed new enhancing renal mass other than treated site during follow up. Total 36 patients (9%) required secondary treatment during follow up period (26 had repeat RFA, 7 had partial nephrectomy and 3 had radical nephrectomy). In total 33 (8.3%) patients deceased during follow up (3 due to metastatic RCC, one due to metastatic prostate cancer and others due to unrelated causes). Kaplan-Meier estimation of radiographic recurrence free survival was 90% at 5 years and 78% at 10 years. Five years cancer specific mortality was less than 1% and all-cause mortality was 8.3% following RFA._x000D_ _x000D_

Conclusions

RFA for renal mass has acceptable local recurrence rate (9.5%) diagnosed with regular follow up and can be effectively treated with secondary procedures. Cancer specific mortality is low (<1%) within median follow-up time of 48 months. This provides an alternate treatment option in selected patients.

Funding

NONE