Renal cancer (2025)

Description

Authors: F. Deschamps and R. Grasso

Reviewers: C. Cantwell, O. van Delden, D. Filippiadis, J. Guirola, R. Iezzi, A. Kovács and R. Uberoi

This course corresponds to chapters 2.2.5.3 Non-vascular interventional oncology and and 2.2.5.3.1 Malignant chest and abdominal disease in the European Curriculum and Syllabus for Interventional Radiology.

Abstract

An increasing number of renal cell carcinomas (RCCs) have been diagnosed in recent years, in part due to incidental detection from the increased use of cross-sectional imaging. The management of small, asymptomatic RCC generates significant controversy. Historically, total nephrectomy has been the treatment of choice for patients. Preservation of renal function, however, is paramount in patients with RCC with comorbid conditions, multiple RCCs, and/or heritable renal cancer syndromes. This need has driven the development of minimally invasive therapeutic alternatives. Although partial nephrectomy is considered the primary treatment, percutaneous ablation is an alternative nephron-sparing approach in these patients.

The main ablation modalities that are used in the treatment of RCC are radiofrequency ablation (RFA), microwave ablation (MWA), and cryoablation (CRA), but the most extensively used and studied are RFA and CRA. Results of large series of renal tumours treated with percutaneous RFA and CRA have demonstrated intermediate-term oncologic control that rivals surgical options with favourable complication profiles. Cryoablation in comparison to RFA has been shown to be more effective in the treatment of large (>3 cm) and centrally located tumours. Early data from small series with microwave ablation have shown similar promising results. Over the past few years, microwave ablation (MWA) has also emerged as a safe and reliable method in the treatment of kidney tumours. MWA provides significantly improved one-year LTR and ablation time compared with cryoablation for patients with RCC. Other outcomes appeared similar or in favour of MWA; however, results were not statistically significant. MWA of primary RCC is as safe and effective as cryoablation.

Learning objectives

• Learn and understand tumour biology and pathology
• Know the relevant tumour classifications and staging
• Know the different IR treatment options for the treatment of small RCCs and their outcomes
• Know which device, probe, probe size, and positions are relevant to the tumour, its location, and size
• Recognise the imaging appearances and end points during treatment, i.e. progress of the ice ball and when to stop
• Learn how to minimise the risk of complications
• Recognise and treat potential complications

Further information

This course covers a basic level of IR knowledge and is designed for trainees, students or young consultants aiming to acquire essential knowledge or prepare for the EBIR exam. Thereby, it is tailored to the European Curriculum and Syllabus for Interventional Radiology and corresponds to chapters 2.2.5.3 Non-vascular interventional oncology and and 2.2.5.3.1 Malignant chest and abdominal disease.

The format of the course is interactive and easy to use, including texts, graphics, videos and a quiz to support your learning. The course duration is around one and half hours and is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to award 1.5 European CME credits (ECMEC). Please note that this course will be taken offline on October 16, 2030.

The enrolment period of this course is linked to the validity of the All-Access Pass.

Release date: October 2025