scholarly journals Decision Making: Thermal Ablation Options for Small Renal Masses

2017 ◽  
Vol 34 (02) ◽  
pp. 167-175 ◽  
Author(s):  
Debra Gervais ◽  
Colin McCarthy
Keyword(s):  
Renal Cell Carcinoma ◽  
Thermal Ablation ◽  
Microwave Ablation ◽  
The United States ◽  
Treatment Modalities ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Advantages And Disadvantages ◽  
Percutaneous Thermal Ablation ◽  
Total Nephrectomy

AbstractRenal cell carcinoma is a relatively common tumor, with an estimated 63,000 new cases being diagnosed in the United States in 2016. Surgery, be it with partial or total nephrectomy, is considered the mainstay of treatment for many patients. However, those patients with small renal masses, typically less than 3 to 4 cm in size who are deemed unsuitable for surgery, may be suitable for percutaneous thermal ablation. We review the various treatment modalities, including radiofrequency ablation, microwave ablation, and cryoablation; discuss the advantages and disadvantages of each method; and review the latest data concerning the performance of the various ablative modalities compared with each other, and compared with surgery.

scholarly journals MP39-01 CHARACTERIZING RECURRENT AND LETHAL SMALL RENAL MASSES IN CLEAR CELL RENAL CELL CARCINOMA USING SOMATIC MUTATIONS

2017 ◽  
Vol 197 (4S) ◽  
Author(s):  
Brandon Manley ◽  
Ed Reznik ◽  
Maria Becerra ◽  
Jozefina Casuscelli ◽  
Daniel Tennenbaum ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Somatic Mutations ◽  
Clear Cell ◽  
Small Renal Masses ◽  
Cell Renal Cell Carcinoma ◽  
Renal Masses

Treating the Two Extremes in Renal Cell Carcinoma: Management of Small Renal Masses and Cytoreductive Nephrectomy in Metastatic Disease

2014 ◽  
pp. e214-e221 ◽  
Author(s):  
Dae Y. Kim ◽  
Christopher G. Wood ◽  
Jose A. Karam
Keyword(s):  
Renal Cell Carcinoma ◽  
Targeted Therapy ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Mass ◽  
Cytoreductive Nephrectomy ◽  
Renal Cell Carcinomas ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Renal Mass Biopsy

OVERVIEW: The incidental renal mass represents a heterogeneous group that contains both benign and malignant pathologies. The majority of renal cell carcinomas are discovered incidentally, without the presence of symptoms directly related to the mass, and are closely associated with the term small renal masses because of the discovery before the onset of symptoms. In general, small renal masses are defined as 4 cm or smaller, and may account for greater than half of renal cell carcinoma diagnosis. The use of renal mass biopsy may offer additional pathological information but the clinician must be reminded of the technical and diagnostic limitations of renal mass biopsy. Patient-dependent factors, such as life expectancy and comorbidities, guide the management of small renal masses, which include active surveillance, partial nephrectomy, radical nephrectomy, and ablative techniques (cryoablation and radiofrequency ablation). Partial nephrectomy has demonstrated durable oncologic control for small renal masses while preserving renal function and, if feasible, is the current treatment of choice. In the other extreme of the renal cell carcinomas spectrum and in the presence of metastatic disease, the removal of the renal primary tumor is termed cytoreductive nephrectomy. Two randomized trials (SWOG 8949 and EORTC 30947) have demonstrated a survival benefit with cytoreductive nephrectomy before the initiation of immunotherapy. These two studies have also been the motivation to perform cytoreductive nephrectomy in the targeted therapy era. Currently, there are two ongoing randomized prospective trials accruing to investigate the timing and relevance of cytoreductive nephrectomy in the contemporary setting of targeted therapy.

scholarly journals Outcomes of Microwave Ablation for Small Renal Masses: A Single Center Experience

2020 ◽  
Vol 34 (11) ◽  
pp. 1134-1140
Author(s):  
Courtney Yong ◽  
Sarah L. Mott ◽  
Sandeep Laroia ◽  
Chad R. Tracy
Keyword(s):  
Microwave Ablation ◽  
Single Center ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Single Center Experience

scholarly journals Small Renal Mass with Sarcomatoid Features

2020 ◽  
Vol 14 (1) ◽  
pp. 54-56
Author(s):  
Anthony D. Oberle ◽  
James A. Brown
Keyword(s):  
Renal Cell Carcinoma ◽  
Renal Mass ◽  
Small Renal Mass ◽  
Common Pathway ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Threshold Size ◽  
Sarcomatoid Renal Cell Carcinoma ◽  
Worse Prognosis ◽  
Sarcomatoid Differentiation

Interest in surveillance for small renal masses has expanded exponentially due to incidental detection with increased imaging. However, some of these small renal masses behave aggressively. Sarcomatoid pathology is associated with a worse prognosis. Traditionally, it has been thought of as a common pathway of dedifferentiation once a renal malignancy of any histology reaches a threshold size of approximately 3 cm. We report a case of a 65-year-old male with a 2 cm sarcomatoid renal cell carcinoma. To our knowledge, this is the smallest tumor with sarcomatoid differentiation reported in the literature.

Cryotherapy and thermal ablation for renal malignancy over 3cm: Comparative analysis of survival with small renal masses.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 531-531
Author(s):  
Alex Jones ◽  
Megan Dinino ◽  
Mark Wakefield ◽  
Katie Murray ◽  
Naveen Pokala
Keyword(s):  
Thermal Ablation ◽  
Univariate Analysis ◽  
Oncological Outcome ◽  
Renal Tumors ◽  
Small Renal Masses ◽  
Cancer Specific Survival ◽  
Renal Masses ◽  
Ablative Therapies ◽  
Node Positive Disease ◽  
Procedure Codes

531 Background: Ablative treatments achieve good oncological outcome for renal parenchymal tumors 3 cm or smaller. Larger renal malignancies are increasingly being treated with ablation. This comparative study determines the survival following ablation in these large renal masses. Methods: Patients undergoing cryotherapy or thermal ablation (Procedure codes 13, 15, or 23) for renal tumors were identified from SEER database (1998-2013). Exclusions: T stage not recorded, more than one primary, metastatic, or node positive disease. Demographics, stage, and overall (OS) and cancer specific survival (CSS) were analyzed. T1a tumors were compared to T1b or T2 tumors. Tumors 3 cm or less were compared to greater than 3 cm. Results: 4886 patients were identified, and 2340 patients met inclusion criteria. The mean age was 66.5 years, 1943 were white, 243 were black, and 1419 were male. The stage distribution included T1a (n=2159), T1b (n=172), and T2 (n=9). 1186 tumors had right sided, 1149 had left ,and the others were bilateral or not specified. 2326 patients had the size recorded and 1637 patients had 3 cm or smaller tumors and 689 tumors were larger than 3 cm. The OS in T1a tumors was 84.4% at 5 years and 69.2% at 9 years. The patients with T1b tumors had 62% at 5 years and 38% at 9 years. The T2 tumors had an OS of 64.8% at 57 months. The 5 yr CSS was 97.4% in the whole group, 97.9% in T1a, and 97.4% in the T1b group. The corresponding 9 yr CSS was 96.9, 97.5, and 96.9%. Comparative CSS in patients with T1a tumors was 98% at 5 years and 97.5% at 9 years. In T1b or greater tumors the 5 and 9 year survival was 90.2%. All patients that survived beyond 5 years were alive at 9 years of follow-up. On analysis by size, tumors 3 cm or less had a 98.4 5-yr and a 98.2 9-yr CSS and tumors that were greater than 3 cm had 95% 5-yr and a 93.9 9-yr survival. On univariate analysis both T1a tumors and tumors smaller than 3 cm had significantly better survival (p=0.001). Conclusions: Ablative therapies for small renal masses can achieve excellent CSS at 97% at 9 years. This study demonstrates that reasonable CSS can be achieved in masses larger than 3 cm and patients with T1b or larger tumors. Further studies are required to address the role of ablative therapies for larger renal masses.

Reporting Standards for Percutaneous Thermal Ablation of Renal Cell Carcinoma

2009 ◽  
Vol 20 (7) ◽  
pp. S409-S416 ◽  
Author(s):  
Timothy W.I. Clark ◽  
Steven F. Millward ◽  
Debra A. Gervais ◽  
S. Nahum Goldberg ◽  
Clement J. Grassi ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Thermal Ablation ◽  
Reporting Standards ◽  
Percutaneous Thermal Ablation
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