Radiofrequency ablation treatment offers an innovative approach for small kidney tumors. It delivers effective results while preventing patients from undergoing major surgery. This method uses high‑frequency radio waves to destroy tumor cells. Additionally, the procedure is supported by imaging techniques, allowing physicians to pinpoint the tumor’s exact location. Treatment does not damage surrounding tissues. This approach is especially important for patients with a single kidney, as radiofrequency ablation helps preserve renal function and carries a low risk of complications.
| Medical Name | Radiofrequency Ablation (RFA) |
| Affected Areas | Kidney (typically small, early‑stage kidney tumors) |
| Indications | Used to treat malignant or benign tumors in the kidney |
| Symptoms | Early‑stage kidney tumors are usually asymptomatic; larger tumors may cause flank pain, hematuria, weight loss |
| Diagnostic Methods | Ultrasound, magnetic resonance imaging (MRI), computed tomography (CT), biopsy |
| Treatment Methods | Radiofrequency ablation (destroying tumor cells with thermal energy), surgery (partial or radical nephrectomy), cryotherapy |
| Possible Complications | Bleeding, infection, damage to surrounding tissues, tumor recurrence |
| Prevention Methods | Regular screening for early tumor detection, healthy lifestyle (avoiding smoking and alcohol, balanced diet) |
| Recovery Time | Patients typically resume normal activities within a few days after RFA |
Prof. Dr. Özgür KILIÇKESMEZ
Interventional Radiology / Interventional Neuroradiology
Who Is the Ideal Candidate for RFA?
Radiofrequency ablation is highly suitable for certain patients, particularly those with small, localized kidney tumors. RFA delivers excellent outcomes for tumors smaller than 4 cm. For slow‑growing tumors, RFA provides effective tumor control. It is also an ideal option for individuals at high surgical risk. This group includes:
- Patients with cardiovascular diseases
- Patients with respiratory issues
These health problems pose significant barriers to surgery, whereas RFA offers a lower‑risk alternative. Recovery is faster and complication rates are lower, enabling patients to recuperate quickly. RFA is also appropriate for those with impaired renal function. It preserves nephrons in patients with a single kidney or renal insufficiency. Because RFA minimizes damage to healthy renal tissue, it better preserves kidney function compared to partial nephrectomy. This treatment targets the tumor without compromising renal performance, thereby enhancing patient quality of life. RFA is an effective and safe option for kidney tumors and offers particular advantages for specific patient groups.
How Is the RFA Procedure Performed?
The radiofrequency ablation procedure for kidney tumors follows a step‑by‑step protocol tailored to the patient’s condition.
Preparation Stage:
- The patient fasts for several hours before the procedure and discontinues specified medications.
- The interventional radiologist and anesthesia team prepare the patient.
- Prior imaging studies (CT or MRI) are reviewed to locate the tumor.
- Laboratory tests are performed if deemed necessary.
Anesthesia:
- Depending on health status and tumor location, sedation under local anesthesia or general anesthesia is chosen.
- General anesthesia is used when enhanced pain control is required.
Biopsy (if needed):
- If no prior biopsy exists, a sample is taken at the start of the procedure.
- Under imaging guidance, a fine needle is inserted into the tumor to collect pathology specimens.
Imaging Guidance:
- Ultrasound, CT, or MRI is used throughout to guide the probe’s placement within the tumor.
- This ensures accurate targeting and spares healthy tissue.
Ablation Process:
- Once the tumor location is confirmed, a needle‑like probe is inserted through the skin.
- High‑frequency electrical currents or microwaves are applied via the probe to ablate cancerous tissue.
Monitoring and Completion:
- The tumor is continuously monitored during ablation.
- Probe temperature is controlled to protect surrounding healthy tissue.
- After ablation, the probe is removed and the radiologist confirms treatment completion.
Post‑Procedure Recovery:
- The patient is observed for several hours after the procedure.
- Mild pain, soreness, or bleeding may occur and is managed with medication.
- Most patients are discharged soon afterward and resume normal activities within 24 hours, though strenuous activities should be avoided for several weeks.
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What Are the Success Rates of RFA?
Radiofrequency ablation offers impressive success rates for small kidney tumors, providing advantages for patients who face high surgical risks. Studies show that five‑year cancer‑specific survival rates for RFA patients are high.
- Five‑year cancer‑specific survival rates typically range from 94% to 98%.
- Local recurrence rates remain low over five years.
- Five‑year recurrence‑free survival is approximately 95%.
Long‑term data confirm RFA’s durable disease control. In well‑selected patients, 15‑year metastasis‑free and cancer‑specific survival approaches nearly 100%. These outcomes demonstrate that RFA is a reliable option for effectively managing small kidney tumors. High success rates enhance patient quality of life and make the treatment itself less burdensome.
What Are the Risks and Complications of RFA?
Radiofrequency ablation carries various potential complications. There is a risk of thermal injury to adjacent organs such as the bowel, which may be mitigated by techniques like hydrodissection.
Damage to Surrounding Tissues: Potential thermal injury to nearby organs.
Bleeding and Hematomas: Increased bleeding risk when tumors are near blood vessels.
- Small hematomas are common.
- Significant bleeding in large tumors may require intervention.
Post‑procedure infections can occur at needle entry sites or deeper tissues and typically require antibiotic therapy.
Thermal Injury to the Urinary System: Ureteral or collecting system damage can lead to urine leaks or strictures.
- Urine leaks and strictures may develop.
- Measures like pyeloperfusion help minimize these risks.
Thrombosis: Blood clots can form during treatment, especially when major vessels are involved.
Local Tumor Recurrence: Recurrence is more likely in larger or centrally located tumors.
Radiofrequency ablation (RFA) applies high‑frequency electrical currents to kidney tumors, generating heat that destroys tumor cells. Studies report primary efficacy rates of 79%–92% for small (T1a, ≤4 cm) kidney tumors. Local tumor progression rates are as low as 2% in some series. Comparative analyses show that RFA yields oncologic outcomes similar to partial nephrectomy but with shorter hospital stays (1.04 days vs. 3.57 days) and fewer complications. Tumor size, proximity to the collecting system, and ablation temperature influence RFA success. Overall, RFA is an effective, minimally invasive option for patients unsuitable for surgery.
RFA is most effective for tumors ≤3 cm, achieving about a 99% success rate in complete ablation for tumors up to 2 cm (~96% complete response). Efficacy declines and local recurrence rates increase for tumors >3 cm, making RFA less recommended for larger lesions.
During RFA, mild pain or nerve injury may occur, especially when tumors are near body wall muscles. Pain or nerve injury rates reach up to 3.9%, with 90% of patients resolving symptoms within six months. Post‑procedure, perinephric hematomas occur in about 14.5% but are usually asymptomatic and require no intervention. Serious complications such as urinary tract injury and drainage needs occur in 1.7%–4.8% of cases. Overall, RFA is safe and well tolerated, with minimal discomfort during and after treatment.
Yes, local recurrence after RFA occurs in 2.5%–10.4% of small kidney tumors. Factors affecting recurrence include tumor size, location, and underlying kidney disease. Nonetheless, RFA remains a nephron‑sparing, minimally invasive option that preserves renal function.
RFA significantly improves quality of life in kidney tumor patients. Studies show notable reductions in pain, improved functional capacity, and better physical health scores post‑treatment. In cancer patients, pain severity decreases by up to 70%, and quality of life improves by up to 40%. Psychological benefits include reductions in depression and anxiety by up to 30%.
Prof. Dr. Özgür Kılıçkesmez graduated from Cerrahpaşa Medical Faculty in 1997. He completed his specialization at Istanbul Education and Research Hospital. He received training in interventional radiology and oncology in London. He founded the interventional radiology department at Istanbul Çam and Sakura City Hospital and became a professor in 2020. He holds many international awards and certificates, has over 150 scientific publications, and has been cited more than 1500 times. He is currently working at Medicana Ataköy Hospital.
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