Ablation rénale : au-delà des standards

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.