Radio-Frequency Thermal Ablation (RFA)
© 2012 Idaho Artery & Vein Clinic
Radio-Frequency Ablation (RFA) uses a small generator to apply a high frequency alternating electric current directly to a body of tissue. A probe is inserted directly into the Tumor and generates heat, which is used to burn the diseased tissue.
Similar to Cryoablation, Renal RF Ablation has been moderately effective and repeat interventions may be required. In one series only 69% had successful ablation with a single treatment [Arzola et al. 2006]. In another study 10.7% had incomplete therapy were required to undergo repeat intervention [Varkarakis et al. 2005]. Repeat intervention decreased the incompletion rate from 14% to 11% in another study [Veltri et al. 2004]. Distant progression of the Cancer can also occur, as has been described by Veltri et al. (2004), and Mahnken et al. (2005), at 19 and 13.9 months, respectively. These progressions revealed malignancy in spite of post-op Imaging showing successful ablation of the treated area and stable renal function.
Similar to Cryoablation, Renal RF Ablation has been moderately effective and repeat interventions may be required. In one series only 69% had successful ablation with a single treatment [Arzola et al. 2006]. In another study 10.7% had incomplete therapy were required to undergo repeat intervention [Varkarakis et al. 2005]. Repeat intervention decreased the incompletion rate from 14% to 11% in another study [Veltri et al. 2004]. Distant progression of the Cancer can also occur, as has been described by Veltri et al. (2004), and Mahnken et al. (2005), at 19 and 13.9 months, respectively. These progressions revealed malignancy in spite of post-op Imaging showing successful ablation of the treated area and stable renal function.
"Skip Areas"
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In addition to high Cancer Recurrence Rates, another concern with RFA has been something termed 'skip areas' of ablation. In this situation certain sections of the tissue remain unablated despite direct application of the RFA therapy. Skipping occurs due to a 'heat-sink' effect, where blood in close proximity to the RF probe effectively carries the heat away from the intended target area. This renders RFA unreliable in highly vascularized Tumors, especially those larger than 3cm. Rosado et al. (2006) in particular found 23% of Tumors to be malignant upon post-op histological work up.
Despite these concerns, RF Ablation may be the most effective option in certain cases. In particular, cases involving the elderly or the infirmed may be best suited, where surgical intervention and Tumor excision may not be viable. |
Source: Valdivia-Uría, et al. UroToday International Journal (2010)
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