Minerva urology and nephrology · 2026
First report of safety and outcomes of radiofrequency ablation of renal tumors using a new automated energy delivery-controlled system.
СтатьяНазвание и аннотация: Перевод в очереди
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Ferrillo Giuseppe, Baldassarre Eleonora, Sirugo Tiziano, Romano Silvio, Lanza Ezio, Poretti Dario, Saita Alberto, Levi Riccardo, Lughezzani Giovanni, Buffi Nicolò M, Casale Paolo, Francone Marco, Pedicini Vittorio
Аннотация
BACKGROUND: The aim of this study was to retrospectively evaluate technical efficacy and safety of radiofrequency ablation (RFA) of renal tumors using a novel RF system.
METHODS: Eighty-two patients with 85 renal tumors (renal cell, papillary and chromophobe carcinomas, oncocytomas and lymphoma) considered unsuitable for surgery by the local Multidisciplinary Board were enrolled for RFA. Tumor location was exophytic in 49.4% of patients, endophytic in 36.5% and central in 14.1%, and tumor size was below 3 cm in 68/85 (80%) cases and between 3.1 and 4.3 cm in the remaining 17 (20%). A new high-power RF system with a maximum power of 370W, a pulsing algorithm for automated control of energy deposition and internally-cooled electrode tip up to 5 cm long was used. Technical success and technique efficacy (also related to size and location of tumors), and safety were evaluated. The follow-up period ranged from 12 to 26 months.
RESULTS: The ablation time was much shorter than with conventional RF systems, ranging between 12 and 15 minutes. At the immediate post-procedural assessment, the technical success was 100%. At the first follow-up evaluation, at two months, primary technique efficacy was achieved in 80/85 (94.1%) cases, without significant differences according to tumor location and size. The 5 partially ablated tumors were successfully retreated and the secondary technique efficacy at 12 months was 100%. Considering only the subgroup of the 45 patients with cyto-histologically proven RCC, the primary technique efficacy was 88.9% (40/45 cases) and the secondary was 100%. Significant complications, CIRSE grade 3, occurred in 3/90 (3.3%) procedures, but only one required treatment (transarterial embolization), while minor complications, all spontaneously remitting, occurred in 27/90 procedures. RFA performed with this new technology proved to be fast, effective and safe, and was associated with shorter procedure times and very few major complications, thus reducing or bridging the gap with MWA and CA.
CONCLUSIONS: RFA performed with this new modality resulted safe and effective and it is associated with short procedural times. The automatic energy-delivery controlled system might overcome limitations due to long procedural times and heat-sink effect in RFA.
METHODS: Eighty-two patients with 85 renal tumors (renal cell, papillary and chromophobe carcinomas, oncocytomas and lymphoma) considered unsuitable for surgery by the local Multidisciplinary Board were enrolled for RFA. Tumor location was exophytic in 49.4% of patients, endophytic in 36.5% and central in 14.1%, and tumor size was below 3 cm in 68/85 (80%) cases and between 3.1 and 4.3 cm in the remaining 17 (20%). A new high-power RF system with a maximum power of 370W, a pulsing algorithm for automated control of energy deposition and internally-cooled electrode tip up to 5 cm long was used. Technical success and technique efficacy (also related to size and location of tumors), and safety were evaluated. The follow-up period ranged from 12 to 26 months.
RESULTS: The ablation time was much shorter than with conventional RF systems, ranging between 12 and 15 minutes. At the immediate post-procedural assessment, the technical success was 100%. At the first follow-up evaluation, at two months, primary technique efficacy was achieved in 80/85 (94.1%) cases, without significant differences according to tumor location and size. The 5 partially ablated tumors were successfully retreated and the secondary technique efficacy at 12 months was 100%. Considering only the subgroup of the 45 patients with cyto-histologically proven RCC, the primary technique efficacy was 88.9% (40/45 cases) and the secondary was 100%. Significant complications, CIRSE grade 3, occurred in 3/90 (3.3%) procedures, but only one required treatment (transarterial embolization), while minor complications, all spontaneously remitting, occurred in 27/90 procedures. RFA performed with this new technology proved to be fast, effective and safe, and was associated with shorter procedure times and very few major complications, thus reducing or bridging the gap with MWA and CA.
CONCLUSIONS: RFA performed with this new modality resulted safe and effective and it is associated with short procedural times. The automatic energy-delivery controlled system might overcome limitations due to long procedural times and heat-sink effect in RFA.