Display options
Share it on

Rev Urol. 2002;4(3):103-11.

Laparoscopic and percutaneous ablative techniques in the treatment of renal cell carcinoma.

Reviews in urology

Kent Perry, Amnon Zisman, Allan J Pantuck, Nicolette Janzen, Peter Schulam, Arie S Belldegrun

PMID: 16985666 PMCID: PMC1475990

Abstract

Widespread use of computed tomography, ultrasound, and magnetic resonance imaging has led to an increase in detection of relatively small renal masses, and approaches to managing them have evolved in the last two decades. Indications for nephron-sparing surgery have expanded, and minimally invasive procedures, which can confer advantages over open surgery, are now available. Ablative techniques offer a combination of nephron-sparing and minimally invasive approaches. Ablative techniques include cryoablation, radiofrequency ablation (RFA), and high-intensity focused ultrasound (HIFU). Cryoablation and RFA have been relatively safe. HIFU has been associated with serious side effects in animal models, and is not yet acceptable for use in humans. Ablative techniques require long-term studies to confirm lasting efficacy. The best modality for tumor targeting, monitoring of therapy, and follow-up is still under investigation. Debate exists regarding the best method for ensuring adequate intraoperative tumor cryoablation. For minimally invasive ablative measures to gain a place as nephron-sparing approaches, they should show both equivalent efficacy and reduced morbidity relative to those of open partial nephrectomy. These techniques should currently be reserved for selected patients and should be compared to the evolving modality of laparoscopic partial nephrectomy.

References

  1. Urology. 1993 Aug;42(2):212-5 - PubMed
  2. JAMA. 1983 May 6;249(17):2357-61 - PubMed
  3. Urology. 2001 May;57(5):976-80 - PubMed
  4. Br J Urol. 1995 Feb;75(2):132-6; discussion 136-7 - PubMed
  5. Cancer. 1994 Jan 1;73(1):160-2 - PubMed
  6. Urology. 1996 May;47(5):772-6 - PubMed
  7. J Endourol. 1997 Aug;11(4):251-8 - PubMed
  8. J Urol. 1996 Jan;155(1):252-4; discussion 254-5 - PubMed
  9. J Endourol. 1997 Jun;11(3):191-6 - PubMed
  10. Urology. 2000 Nov 1;56(5):748-53 - PubMed
  11. Urology. 2001 Jan;57(1):34-9 - PubMed
  12. J Ultrasound Med. 1998 Sep;17(9):571-6 - PubMed
  13. Eur Urol. 1992;22(2):147-52 - PubMed
  14. Urology. 2001 Dec;58(6):988-93 - PubMed
  15. Urology. 1999 Mar;53(3):465-72; discussion 470-2 - PubMed
  16. Circulation. 1992 Apr;85(4):1337-46 - PubMed
  17. Eur Urol. 1993;23 Suppl 1:34-8 - PubMed
  18. J Urol. 1997 Feb;157(2):710-2 - PubMed
  19. Urology. 1998 May;51(5A Suppl):161-6 - PubMed
  20. Lancet. 1995 Aug 5;346(8971):350-1 - PubMed
  21. Urology. 2000 Jan;55(1):25-30 - PubMed
  22. Cryobiology. 1997 Jun;34(4):373-84 - PubMed
  23. Urology. 1998 Oct;52(4):543-51 - PubMed
  24. Cryobiology. 1999 Feb;38(1):89-93 - PubMed
  25. Obstet Gynecol. 1990 Nov;76(5 Pt 1):876-81 - PubMed
  26. Urol Clin North Am. 1987 May;14(2):419-33 - PubMed
  27. J Urol. 1993 Jan;149(1):1-7 - PubMed
  28. Urology. 2000 Aug 1;56(2):190-6 - PubMed
  29. J Urol. 1990 Oct;144(4):852-7; discussion 857-8 - PubMed
  30. J Urol. 1989 Apr;141(4):835-9 - PubMed
  31. J Urol. 1969 Mar;101(3):297-301 - PubMed
  32. Br J Radiol. 1995 Dec;68(816):1296-1303 - PubMed
  33. Cancer J Sci Am. 1995 May-Jun;1(1):73-81 - PubMed
  34. J Urol. 2001 Nov;166(5):1611-23 - PubMed
  35. Urology. 1998 Jul;52(1):29-33; discussion 33-4 - PubMed
  36. J Clin Oncol. 1999 Sep;17(9):2868-75 - PubMed
  37. J Urol. 2000 May;163(5):1424-7 - PubMed
  38. J Nerv Ment Dis. 1961 Sep;133:259-63 - PubMed
  39. Urology. 2002 Jan;59(1):130-3 - PubMed
  40. Radiology. 2000 Dec;217(3):665-72 - PubMed
  41. J Endourol. 2000 Dec;14 (10 ):873-8; discussion 878-9 - PubMed
  42. Semin Urol Oncol. 2001 May;19(2):114-22 - PubMed
  43. Urology. 1994 Feb;43(2):160-8 - PubMed
  44. J Endourol. 1996 Feb;10(1):71-5 - PubMed
  45. Radiology. 1989 Mar;170(3 Pt 1):699-703 - PubMed
  46. CA Cancer J Clin. 2001 Jan-Feb;51(1):15-36 - PubMed

Publication Types