Preliminary experience using high intensity focused ultrasound for the treatment of patients with advanced stage renal malignancy.

PURPOSE We present the preliminary results of patients with advanced stage renal malignancy treated with high intensity focused ultrasound (HIFU), and investigate the safety and feasibility of using HIFU in the treatment of selected patients with renal tumors. MATERIALS AND METHODS HIFU treatment was performed in 12 patients with advanced stage renal cell carcinoma and 1 patient with colon cancer metastasized to kidney. Patients were followed after treatment to observe complications and long-term therapeutic efficacy. Complications and changes in symptoms seen at presentation were recorded. Mid stream urine specimens were sent for microscopy and serum creatinine was measured postoperatively. Followup radiological examinations were performed to detect tumor response to the ablation. RESULTS A total of 13 patients received HIFU treatment safely, including 10 who had partial ablation and 3 who had complete tumor ablation. After HIFU hematuria disappeared in 7 of 8 patients and flank pain of presumed malignant origin disappeared in 9 of 10 patients. Postoperative images showed decrease in or absence of tumor blood supply in the treated region and significant shrinkage of the ablated tumor. Of the 13 patients 7 died (median survival 14.1 months, range 2 to 27) and 6 were still alive with median followup of 18.5 months (range 10 to 27). CONCLUSIONS This preliminary experience suggests that HIFU could be safe and feasible in the treatment of patients with advanced renal malignancy.