Focal Ablative Therapy for Localized Kidney Cancer

The incidence of renal cell carcinoma has increased due to the recent widespread use of abdominal imaging. Treatment modalities for renal masses range from active surveillance to nephrectomy. While partial nephrectomy and nephrectomy continue to be the gold standard treatment, other therapies are growing in use. Particularly with the rise of diagnosed small renal masses, minimally invasive thermal ablation therapies have emerged and most commonly include radiofrequency ablation and cryoablation. The current practice of minimally invasive ablation has expanded along with the continuous improvement and development of technology. Long-term follow-up data after cryoablation and radiofrequency ablation have proven their effectiveness over time. Thermal ablation for renal masses is safe with minimal morbidity. In this chapter, we will discuss the current state of thermal ablation including cryoablation and radiofrequency ablation. We will provide details on the indications for thermal ablation, the role of renal mass biopsy, percutaneous techniques, emerging ablative therapies, and perioperative outcomes. Finally, we will discuss the long-term oncologic outcomes of thermal ablation as well as the results of salvage ablation.