Purpose To evaluate the oncological outcomes complications and changes in renal function in patients treated with computed tomography-guided percutaneous radiofrequency ablation (RFA) for small renal tumors. pain or elevated temperature) and grade II complications in 2.3% (n=1 perirenal bleeding needing two units of blood transfusion). Serum creatinine slightly increased by 0.14 mg/dL at 2 years after RFA (p<0.004). Tumor recurrences were suspected in 8 of 43 cases during follow-up. In five patients the suspected recurrence was a false-positive as shown by a negative biopsy result or lack of contrast enhancement on subsequent imaging. The verified recurrence rate was 7.7% in all tumors and 2.5% in RCC at a mean follow-up of 2 years. Tumor-free survival was 90% in all patients and 87.5% in those with RCC. Metastasis-free survival was 97.5% and cancer-specific survival was 100%. Conclusions Percutaneous computed tomography-guided RFA shows promising results at intermediate follow-up. Suspected tumor recurrences are frequently false-positives findings. A longer follow-up is required to verify the durability of these results. Keywords: Ablation techniques Kidney neoplasms Minimally invasive surgical procedures Renal cell carcinoma INTRODUCTION Renal cell carcinoma (RCC) is among the most frequent malignant tumors with significant morbidity and mortality. More than 58 0 estimated new cases and more than 13 0 deaths occurred in the United States in 2010 2010 [1]. During the last decades an increase in the incidence of all clinical stages of renal tumors was observed with the greatest increase for localized tumors [2]. Owing to the wide use of cross-sectional abdominal studies such as ultrasound computed tomography (CT) and magnetic resonance imaging (MRI) the detection rate of small solid lesions has increased with up to 66% of tumors found incidentally [3]. The majority of incidentally diagnosed RCC tends to be of smaller size and thus is more likely to be asymptomatic show a lower histological grade and have a decreased incidence of metastasis [4]. Radiofrequency ablation (RFA) is a novel minimally invasive therapeutic approach that should be offered to patients with small renal tumors with a size less than 4 cm in diameter or significant comorbidities precluding surgical resection [5]. In the need for a therapeutic approach for such selected cases RFA was established at our institution in 2006. In the present study we sought to assess Mouse monoclonal to CD86.CD86 also known as B7-2,is a type I transmembrane glycoprotein and a member of the immunoglobulin superfamily of cell surface receptors.It is expressed at high levels on resting peripheral monocytes and dendritic cells and at very low density on resting B and T lymphocytes. CD86 expression is rapidly upregulated by B cell specific stimuli with peak expression at 18 to 42 hours after stimulation. CD86,along with CD80/B7-1.is an important accessory molecule in T cell costimulation via it’s interaciton with CD28 and CD152/CTLA4.Since CD86 has rapid kinetics of induction.it is believed to be the major CD28 ligand expressed early in the immune response.it is also found on malignant Hodgkin and Reed Sternberg(HRS) cells in Hodgkin’s disease. the efficacy complications and changes in renal function in our initial cases after an intermediate follow-up period. MATERIALS AND METHODS We reviewed the charts of patients Rivaroxaban who underwent RFA between 2006 and 2011. Percutaneous RFA was offered to highly selected patients whose renal tumors did not exceed 40 mm in diameter. Patient selection Rivaroxaban was limited to subjects with advanced age and severe comorbidities that would cause a high surgical risk impaired renal function prior to treatment a functional or anatomical solitary kidney or bilateral renal tumors or patients who refused tumor resection. 1 Renal biopsy and RFA procedure After an initial implementation and learning process during which no renal biopsies were done biopsies were routinely performed a few days before RFA under CT guidance. Biopsies were taken with an 18-Fr needle under local anesthesia. The specimens were fixed with hematoxylin-eosin staining. All RFAs were performed under general anesthesia with a Rita device (Model 1500 RF Generator 25 cm StarBurst XL Semi-Flex RFA Device Angiodynamics Queensbury NY USA) by an interventional radiologist. According to the kidney Rivaroxaban protocol of the Rita device the maximum power to achieve a target temperature of 105℃ was 150 W. Depending on the target size the time of each cycle varied. For a desired ablation Rivaroxaban defect of 20 mm we used 5 minutes at the target temperature with a reset time of 5 minutes with a second identical cycle. For a 30-mm defect we analogously used 7 minutes and for a 40-mm defect 8 minutes. If necessary overlapping ablations were performed by repositioning the probe and restarting the procedure. At the end of the ablation after the probe had been removed a control CT scan verified the ablation and.