Comparison of General Anesthesia and Conscious Sedation During Computed Tomography–Guided Radiofrequency Ablation of T1a Renal Cell Carcinoma

Abstract Purpose Percutaneous radiofrequency ablation is so painful that this treatment requires pain control such as conscious sedation or general anesthesia. It is still unclear which type of anesthesia is better for treatment outcomes of renal cell carcinoma. This study aimed to compare general anesthesia and conscious sedation in treating patients with renal cell carcinoma with radiofrequency ablation. Methods Between 2010 and 2015, 51 patients with biopsy-proven renal cell carcinomas ( Results The mean tumour size was 2.1 cm in both groups ( P  = .673). Local tumour progression occurred in 0% (0 of 41) of the general anesthesia group, but in 40% (4 of 10) of the conscious sedation group ( P  = .001). Metastases in these groups occurred in 2.4% (1 of 41) of the general anesthesia group and 20% (2 of 10) of the conscious sedation group ( P  = .094). No major complications developed in either group after the first radiofrequency ablation session. The mean effective doses in these groups were 21.7 mSv and 21.2 mSv, respectively ( P  = .868). The mean glomerular filtration rate differences in the general anesthesia and conscious sedation groups were -13.5 mL/min/1.73 m 2 and -19.1 mL/min/1.73 m 2 , respectively ( P  = .575). Three-year recurrence-free survival rates in these groups were 97.6% and 60.0%, respectively ( P  = .001). Conclusions General anesthesia may provide better intermediate outcomes than conscious sedation in treating small renal cell carcinomas with radiofrequency ablation.