Thermal ablative technologies have evolved considerably in the recent past for the
treatment of small renal masses and the application of ablative modalities for small
renal masses continues to increase.
Radiofrequency ablation and cryoablation continue to be the most often used ablative
modalities for the treatment of small renal masses and they have intermediate-term
oncologic control that rivals surgical options with a favorable complication profile. The
Mayo clinic has recently publish a study comparing partial nephrectomy and
percutaneous ablation for treatment of renal masses showing near equivalent
outcomes among patients treated with PN. Studies comparing cryoablation and
radiofrequency ablation show no significant difference in oncologic control or
complication profile between the two modalities. European Association of Urology
has defined guidelines that can be challenged in the light of those recent
improvements. Early data from small series with microwave ablation have shown
similar promising results. Newer technologies including irreversible electroporation
and high-intensity–focused ultrasound have theoretical advantages to RFA and cryo,
but will require further study to be used optimally.