Cryoablation versus radiofrequency ablation for renal tumor ablation: Time to reassess?

摘要

Of the widely available methods for renal tumor ablation, cryoablation was the first to be assessed in the treatment of renal cell carcinoma (RCC) by using open surgical approaches. Open surgical access was necessary because early cryoprobes were too large for percutaneous application. Initial evaluation of percutaneous approaches to renal tumor ablation in humans included a "treat-and-resect" case reported by Zlotta et al (1) in 1997 and the first case with ablation as the sole planned treatment reported by McGovern et al (2) in 1999. With the advent of percutaneous needle applicators, renal tumor ablation moved to interventional radiology suites with ultrasound (US), computed tomography, and, in some cases, magnetic resonance imaging guidance. With percutaneous cryoprobes available shortly thereafter, the next several years saw expansion of the use of percutaneous image-guided radiofrequency (RF) ablation and cryoablation of renal tumors. Most recently, newer modalities such as microwave (MW) ablation and irreversible electroporation (IRE) have been assessed, and even promoted by some, to treat small tumors.