# Is radiofrequency ablation of renal cancer metastases a suitable alternative to surgical metastectomy: A systematic review

## TL;DR

This study reviews whether radiofrequency ablation is a safe and effective alternative to surgery for treating kidney cancer metastases.

## Contribution

This is the first systematic review evaluating RFA for metastatic renal cell carcinoma.

## Key findings

- RFA showed acceptable oncological outcomes comparable to surgical metastectomy.
- Overall survival rates ranged from 50 to 100% at five years post-RFA.
- Complication risks were low, with 30% pneumothorax and 0.1% mortality per treated metastasis.

## Abstract

Percutaneous ablative procedures such as radiofrequency ablation (RFA) are recognised as safe and effective treatment for small renal masses. These techniques are routinely used for metastases of other cancers such as lung or colorectal cancer.

We aim to assess the feasibillity and safety of these treatments for metastatic RCC.

A systematic review of the literature was performed searching for primary papers reporting outcomes on percutaneous ablative procedures such as RFA or cryoablation for the treatment of metastases of RCC. The study is registered with PROSPERO and is conducted in line with PRISMA guidelines.

Seven studies were identified with a total of 752 patients undergoing 961 radiofrequency ablation sessions for 1423 metastases were included in this systematic review. Of the seven studies, 4 were single centre retrospective cohort studies, 2 were multi-centre retrospective cohort studies and 1 was monocentric prospective study.

The mean age of patients in this study is 63.74 years and 34.4% were female. Mean follow up ranged from 10 to 61 months. Mean tumour size ranged from 12 to 79 mm. Overall Survival ranges from 50 to 100% from 5 years onwards post RFA. Overall we report a 30% risk of pneumothorax, 1.2% risk of non-pneumothorax complication and 0.1% risk of death per metastases treated.

This is the first systematic review on this subject. We have shown that RFA can be safely used for metastatic RCC. It demonstrates acceptable oncological outcomes, comparable to surgical metastectomy.