OBJECTIVE: Although radio-frequency ablation (RFA) has been recently applied as 
a minimally invasive treatment option for renal cell carcinoma (RCC), indication 
of this modality remains a critical issue due to the lack of complete tumor 
destruction as well as the uncertainty of its long-term efficacy. We report the 
efficacy of RFA for nine carefully selected patients with RCC who had 
significant reason to avoid invasive surgical treatment under general 
anesthesia.
METHODS: Radio-frequency ablation was performed under epidural or local 
anesthesia by ultrasound or computed tomography (CT) guidance in nine patients 
with biopsy proven RCC (mean diameter, 38 mm; range, 20-53 mm), who were at 
significant operative or anesthetic risk for invasive surgery. Follow-up 
enhanced CT scans or magnetic resonance images were evaluated every 3-6 months 
and an evaluation of metastasis was performed every 6 months.
RESULTS: At a mean follow-up of 17 months, seven (78%) of the nine patients with 
renal tumor showed no tumor enhancement. The renal function of all patients was 
well preserved. All patients were able to continue undergoing their respective 
treatments for active diseases in other organs in parallel to the RFA treatment. 
No distant metastasis, urine leakage were reported and one case of temporary 
hematuria and one case of peri-renal hemorrhage not requiring blood transfusion 
were encountered. Intra-operative ultrasonography was useful in the real-time 
monitoring of the minimally excessive extension of ablation into the normal 
parenchyma.
CONCLUSION: Radio-frequency ablation appears to be an effective and safe 
minimally invasive therapeutic option for selected patients with RCC who have 
reason to avoid invasive surgery under general anesthesia.