RCC involves adjacent organs in 10% of cases. Five-year survival rate is less than 5% with a high risk of disease recurrence with rates ranging from 50–85% depending on tumour state and lymph node involvement.1
Despite advances in adjuvant systemic treatments for RCC, surgical resection continues to be the best option for improved long-term survival in selected patients with RCC and liver involvement by contiguity.2 3
Johnin K et al
reported two patients with renal tumour invading the liver who had radical nephrectomy and liver resection and showed no evidence of disease at 100 and 57 months after resection.4
One patient with locally invasive RCC required resection of the kidney, adrenal glands, liver, diaphragm and lung, with diaphragmatic reconstruction. The patient was alive and well at 5 years.3
Karellas et al
reported improved survival with extended resection.5
Applying bipolar radiofrequency energy to an electrode array can enable transmural excision of renal parenchyma in a bloodless way () without incurring system injury6
and without renal pedicle clamping.7
Ablation results in complete cell destruction.8
Neoadjuvant strategies that integrate aggressive surgical intervention with systemic treatment may be a promising treatment paradigm.9
- Aggressive surgical treatment improves survival in cases of RCC with direct liver invasion.
- Radiofrequency assisted resection technique helps to achieve nephron sparing renal surgery.