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Radio-frequency ablation helps preserve nephrons in salvage of failed microwave ablation for a renal cancer in a solitary kidney

Recurrent tumors after renal ablative therapy present a challenge for clinicians. New ablative modalities, including microwave ablation (MWA), have very limited experience in methods of retreating ablation failures. Additionally, in MWA, no long-term outcomes have been reported. In patients having l...

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Autores principales: Castle, Scott M., Salas, Nelson, Leveillee, Raymond J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3643323/
https://www.ncbi.nlm.nih.gov/pubmed/23662010
http://dx.doi.org/10.4103/0974-7796.106966
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author Castle, Scott M.
Salas, Nelson
Leveillee, Raymond J.
author_facet Castle, Scott M.
Salas, Nelson
Leveillee, Raymond J.
author_sort Castle, Scott M.
collection PubMed
description Recurrent tumors after renal ablative therapy present a challenge for clinicians. New ablative modalities, including microwave ablation (MWA), have very limited experience in methods of retreating ablation failures. Additionally, in MWA, no long-term outcomes have been reported. In patients having local tumor recurrence, options for surveillance or surgical salvage must be assessed. We present a case to help assess radio-frequency ablation (RFA) for salvage of failed MWA. We report a 63-year-old male with a 4.33-cm renal mass in a solitary kidney undergoing laparoscopic MWA with simultaneous peripheral fiber-optic thermometry (Lumasense, Santa Clara, CA, USA) as primary treatment. Follow-up contrast-enhanced computed tomography (CT) scan was performed at 1 and 4.3 months post-op with failure occurring at 4.3 months as evidenced by persistent enhancement. Subsequently, a laparoscopic RFA (LRFA) with simultaneous peripheral fiber-optic thermometry was performed as salvage therapy. Clinical and radiological follow-up with a contrast-enhanced CT scan at 1 and 11 months post-RFA showed no evidence of disease or enhancement. Creatinine values pre-MWA, post-MWA, and post-RFA were 1.01, 1.14, and 1.17 mg/ml, respectively. This represents a 15% decrease in estimated glomerular filtration rate (eGFR) (79 to 67 ml/min) post-MWA and no change in eGFR post-RFA. Local kidney tumor recurrence often requires additional therapy and a careful decisionmaking process. It is desirable not only to preserve kidney function in patients with a solitary kidney or chronic renal insufficiency, but also to achieve cancer control. We show the feasibility of RFA for salvage treatment of local recurrence of a T1b tumor in a solitary kidney post-MWA.
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spelling pubmed-36433232013-05-09 Radio-frequency ablation helps preserve nephrons in salvage of failed microwave ablation for a renal cancer in a solitary kidney Castle, Scott M. Salas, Nelson Leveillee, Raymond J. Urol Ann Case Report Recurrent tumors after renal ablative therapy present a challenge for clinicians. New ablative modalities, including microwave ablation (MWA), have very limited experience in methods of retreating ablation failures. Additionally, in MWA, no long-term outcomes have been reported. In patients having local tumor recurrence, options for surveillance or surgical salvage must be assessed. We present a case to help assess radio-frequency ablation (RFA) for salvage of failed MWA. We report a 63-year-old male with a 4.33-cm renal mass in a solitary kidney undergoing laparoscopic MWA with simultaneous peripheral fiber-optic thermometry (Lumasense, Santa Clara, CA, USA) as primary treatment. Follow-up contrast-enhanced computed tomography (CT) scan was performed at 1 and 4.3 months post-op with failure occurring at 4.3 months as evidenced by persistent enhancement. Subsequently, a laparoscopic RFA (LRFA) with simultaneous peripheral fiber-optic thermometry was performed as salvage therapy. Clinical and radiological follow-up with a contrast-enhanced CT scan at 1 and 11 months post-RFA showed no evidence of disease or enhancement. Creatinine values pre-MWA, post-MWA, and post-RFA were 1.01, 1.14, and 1.17 mg/ml, respectively. This represents a 15% decrease in estimated glomerular filtration rate (eGFR) (79 to 67 ml/min) post-MWA and no change in eGFR post-RFA. Local kidney tumor recurrence often requires additional therapy and a careful decisionmaking process. It is desirable not only to preserve kidney function in patients with a solitary kidney or chronic renal insufficiency, but also to achieve cancer control. We show the feasibility of RFA for salvage treatment of local recurrence of a T1b tumor in a solitary kidney post-MWA. Medknow Publications & Media Pvt Ltd 2013 /pmc/articles/PMC3643323/ /pubmed/23662010 http://dx.doi.org/10.4103/0974-7796.106966 Text en Copyright: © Urology Annals http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Castle, Scott M.
Salas, Nelson
Leveillee, Raymond J.
Radio-frequency ablation helps preserve nephrons in salvage of failed microwave ablation for a renal cancer in a solitary kidney
title Radio-frequency ablation helps preserve nephrons in salvage of failed microwave ablation for a renal cancer in a solitary kidney
title_full Radio-frequency ablation helps preserve nephrons in salvage of failed microwave ablation for a renal cancer in a solitary kidney
title_fullStr Radio-frequency ablation helps preserve nephrons in salvage of failed microwave ablation for a renal cancer in a solitary kidney
title_full_unstemmed Radio-frequency ablation helps preserve nephrons in salvage of failed microwave ablation for a renal cancer in a solitary kidney
title_short Radio-frequency ablation helps preserve nephrons in salvage of failed microwave ablation for a renal cancer in a solitary kidney
title_sort radio-frequency ablation helps preserve nephrons in salvage of failed microwave ablation for a renal cancer in a solitary kidney
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3643323/
https://www.ncbi.nlm.nih.gov/pubmed/23662010
http://dx.doi.org/10.4103/0974-7796.106966
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