Long-term Clinical Outcomes of Radiofrequency Ablation for Pathologically Diagnosed T1a Renal Cell Carcinoma: A 10-Year Single-center Experience

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Purpose: Radiofrequency ablation is a useful alternative to surgery for small renal cell carcinoma in nonsurgical candidates; however, its long-term clinical outcomes remain controversial. This study evaluated the long-term outcomes of radiofrequency ablation in patients with pathologically diagnosed T1a renal cell carcinoma. Material and Methods: This single-center retrospective study included 60 consecutive patients (median age, 67.0 years) who underwent radiofrequency ablation for 62 pathologically diagnosed T1a renal cell carcinomas between 2002 and 2014, all without prior renal cell carcinoma or other active malignancies. Tumor diameters ranged from 1.0 to 3.9 cm (median, 2.3 cm), and 22 (35.5%) renal cell carcinomas were centrally located. Overall and cancer-specific survival, local tumor control, and complications were evaluated. Results: Complete tumor ablation was achieved in 53 renal cell carcinomas (85.5%) after the initial radiofrequency ablation and in all renal cell carcinomas after the second radiofrequency ablation. The local tumor control rates were 96.3% (95% confidence interval, 91.2%-100%) and 91.6% (95% confidence interval, 83.6%-99.6%) at 5 and 10 years, respectively. During a median follow-up period of 9.0 years (range, 1.3-16.5 years), renal cell carcinoma-related death in only one (1.7%) patient. Overall and cancer-specific survival rates were 98.3% (95% confidence interval, 94.9%-100%) and 100% at 5 years, and 85.7% (95% confidence interval, 75.0%-96.4%) and 97.4% (95% confidence interval, 92.5%-100%) at 10 years. Univariate analysis identified diabetes mellitus (p = 0.007) and chronic kidney disease (p = 0.039) as significant prognostic factors. No procedure-related deaths or major complications were observed. Dialysis was initiated in four (6.7%) patients. Conclusions: Radiofrequency ablation is a safe procedure with strong anticancer effects and contributes to the long-term prognosis of patients with T1a renal cell carcinoma.

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