Abstract: Abstract: Objective To investigate the outcome of the combination of radiofrequency ablation (RFA) and open surgery for treating spinal metastases in clear cell renal cell carcinoma (CCRCC). Methods From April 2009 to October 2013, 31 CCRCC cases with spinal metastases were reviewed retrospectively in the present study, including 24 males and 7 females, with an average age of (55.3±10.5) years (range, 35~71 years). All the patients were divided into two groups based on the received treatment, including combinative treatment group (received the combinative treatment of RFA and surgery, n=13) and surgery group (received surgery without RFA application, n=18). Blood loss and intra-operative time were compared between the two groups. Pain levels were assessed by visual analogue scale (VAS). Neurologic deficit was evaluated by Frankel grade, and function was classified by Karnofsky Score (KPS). The quality of the life was assessed by EORTC QLQ-C30 (Version 3.0) questionnaire. Survival time was also analyzed after treatment. Results The period of follow-up ranged from 10 to 50 months with the average of (26.65±1.96) months. The blood loss was (1 488.46±629.87) mL in combinative treatment group, which was significantly less than that in surgery group (2 050.00±726.19) mL (P＜0.05). The intra-operative time (221.54 ± 79.04) min was significantly reduced in the combinative treatment group than that of surgery group (291.11±95.29 min, P＜0.05). VAS scores significantly decreased 3 months and 6 months after treatment in the two groups (P＜0.01). The proportion of Frankel grade (Grade D and E) increased from 53.8% (pre-operation) to 84.6% (post-operation) in the combinative treatment group (P＜0.05), while surgery group showed the significant change from 66.7% (pre-operation) to 88.9% (post-operation, P＜0.01). Compared with pre-operative KPS score, the proportion of KPS score (80-100) increased by 38.4% and 27.8% 3 months after operation in combinative treatment group and surgery group, respectively. The functional state improved significantly after treatment is both groups (P＜0.05). Conclusion The combination of RFA and surgery is a safe and efficacy treatment strategy for clear cell renal cell carcinoma patients with spinal metastases, which can significantly reduce the blood loss and intra-operative time in surgery.

Key words:  kidney neoplasms, adenocarcinoma, clear cell, spine, neoplasm metastasis, catheter ablation, surgical procedures, operative