January 31, 2003

ADVANCES
Minimally invasive treatment successfully destroys kidney tumors

A minimally invasive, experimental treatment is proving successful in removing small kidney tumors from appropriate patients. In the February issue of Radiology, an MGH research team describes how radiofrequency ablation (RFA) destroyed all renal cell carcinoma tumors less than 3 cm in size and some larger tumors, depending on their location.

"We're very pleased with the success we've had, particularly treating small tumors and those on the outside of the kidney," says Debra Gervais, MD, of MGH Radiology, the paper's first author. "We now have another year of experience beyond what is reported in this paper — more than 30 additional patients — with similar results."

RFA delivers heat generated by electrical energy to tumor sites through a thin needle, similar to probes used in biopsy procedures. It also is used to treat cardiac arrhythmias, small liver tumors and a benign bone tumor called osteoid osteoma. Researchers at several centers have tried it for patients with kidney tumors for whom surgical removal was not an option — including patients with only one kidney.

The MGH researchers describe the outcomes for the first 34 consecutive patients treated with RFA — with 42 individual tumors — over a three-and-a-half-year period. All tumors located on the surface of the kidney were completely destroyed, regardless of size. Although larger tumors within the central kidney were more difficult to treat, more than half of such tumors were destroyed with additional treatments.

Peter R. Mueller, MD, MGH director of Abdominal Imaging and the paper's senior author, says, "Even patients with multiple tumors can be treated as outpatients and maintain good kidney function." W. Scott McDougal, MD, chief of Urology at MGH, adds, "I am optimistic that, with further study, RFA will someday become the standard of care for selected kidney tumors." Other MGH co-authors of the report are Francis McGovern, MD, urologist, and Ronald Arellano, MD, radiologist.