Repeat Percutaneous Radiofrequency Ablation of T1 Renal Cell Carcinomas is Safe in Patients with Von Hippel-Lindau Disease

Cardiovasc Intervent Radiol. 2021 Dec;44(12):2022-2025. doi: 10.1007/s00270-021-02935-w. Epub 2021 Aug 19.

Abstract

Purpose: Patients with Von Hippel-Lindau disease often develop multifocal, metachronous renal cell carcinomas which require therapy. The purpose of this retrospective single-center study is to evaluate the outcomes of radiofrequency ablation (RFA) in the treatment of renal cell carcinomas in patients with Von Hippel-Lindau disease.

Materials and methods: 9 patients (4 male, 5 female, 47.9 ± 10.7 y/o) with Von Hippel-Lindau disease underwent 18 CT-guided percutaneous RFA procedures for the treatment 21 renal cell carcinomas (largest diameter: 32.9 ± 8.6 mm, cT1a: 16, cT1b: 5). Seven patients were previously treated either by partial or radical nephrectomy. Technical success, effectiveness, safety, progression-free survival, overall survival and tumor characteristics were analyzed.

Results: All RFA procedures were technically successful without major complications. There were 5 minor complications. No residual or recurrent tumor was seen in the ablation zone during a follow-up of 34.0 ± 18.1 months (0-58 months). No patient required dialysis during follow-up. One patient died after 63 months after the first treatment due to complications from a cerebellar hemangioblastoma. No endpoint was reached for overall or progression-free survival.

Conclusions: The results from this limited case series suggest that RFA of RCCs in patients with VHL is a safe and effective therapy, which can preserve sufficient renal function even after renal surgery.

Keywords: Radiofrequency ablation; Renal cell carcinoma; Renal mass; Renal tumor; Von Hippel–Lindau disease.

MeSH terms

  • Adult
  • Carcinoma, Renal Cell* / diagnostic imaging
  • Carcinoma, Renal Cell* / surgery
  • Catheter Ablation*
  • Female
  • Humans
  • Kidney Neoplasms* / diagnostic imaging
  • Kidney Neoplasms* / surgery
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Radiofrequency Ablation*
  • Retrospective Studies
  • von Hippel-Lindau Disease* / complications
  • von Hippel-Lindau Disease* / surgery