Percutaneous CT-guided Radiofrequency Ablation for Renal Cell Carcinoma in von Hippel-Lindau Disease: Midterm Results

Purpose: To evaluate the safety and midterm results of radiofrequency (RF) ablation for the treatment of renal cell carcinoma (RCC) in patients with von Hippel-Lindau (VHL) disease. Materials and methods: This study included 13 patients with VHL (8 women and 5 men; mean age: 35.5 years) and RCC. Each patient presented with 1-6 RCCs (mean: 2.4 ± 1.7) without extrarenal metastasis. The mean tumor diameter was 18.0 ± 5.0 mm. Transcatheter arterial embolization was performed for 5 (16.7%) of 31 tumors. All RF ablation procedures involved the percutaneous use of internally cooled RF electrodes under computed tomography fluoroscopic guidance. Adverse events were evaluated using the Common Terminology Criteria for Adverse Events, version 4.0, and preand post-treatment estimated glomerular filtration rates (eGFRs) were compared using paired t-tests. Local tumor progression, distant metastasis, and survival were also evaluated. Results: Twenty-three RF ablation sessions were technically successful. A grade 3 adverse event (hydronephrosis due to blood clotting, thus requiring ureteral stent placement) occurred in 1 (4%) of 23 sessions. The mean eGFR measured at 1 month after ablation was significantly lower than the mean eGFR before ablation (70.2 ± 21.9 versus 78.8 ± 23.0, p < 0.001). Local tumor progression was seen in 1 (3%) of 31 tumors. No patients died, required dialysis, or developed extra-renal metastases during a median 40-month follow-up. Conclusions: RF ablation for RCC is a safe, highly effective, and promising treatment option for patients with VHL disease.