Ultrasound-guided percutaneous laser ablation is safe and effective in the treatment of small renal tumors in patients at increased bleeding risk

The aim of this retrospective study was to assess the safety and effectiveness of laser ablation (LA) in patients with small renal cell carcinomas (RCC) and increased risk of bleeding.

From 2013 to 2017, nine patients (six males, three females, aged 68. 5 ± 12.2 years) at high risk of bleeding underwent ultrasonography-guided LA for an RCC. Patients were considered at increased risk of bleeding because of impairment of coagulation parameters, concomitant antiplatelet therapy, or at-risk location of the tumor (one, five, and three patients, respectively). RCC diameter ranged from 11 to 23 mm. According to tumor size, two or three laser fibers were introduced through 21-gauge needles and 1800 J per fiber were delivered in 6 min with a fixed power of 5 W. Major and minor complications, technical success, and primary and secondary technical effectiveness and tumor recurrence were recorded.

Just one Grade 1 complication was observed: a small asymptomatic hematoma that spontaneously resolved. Technical success was 100%, 1 month technical efficacy was 88.9% (8/9 patients). One patient with residual tumor was successfully retreated 1 month later, and secondary efficacy rate was 100%. No local tumor recurrence occurred during a median follow-up of 26 months (range 11-49 months).

LA is safe and effective in the treatment of small RCC and might represent a valid option in patients with increased risk of bleeding.

International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group. 2018 May 11 [Epub ahead of print]

Sergio Sartori, Giovanni Mauri, Paola Tombesi, Francesca Di Vece, Lara Bianchi, Claudio Maurizio Pacella

a Section of Interventional Ultrasound, Department of Internal Medicine , St. Anna Hospital , Ferrara , Italy., b Department of Interventional Radiology , European Institute of Oncology , Milan , Italy., c Department of Diagnostic Imaging and Interventional Radiology , Regina Apostolorum Hospital , Albano Laziale, Rome , Italy.