A Feasibility Study for a Multicentre Randomised Controlled Trial to Compare Surgery With Needle Ablation Techniques in People With Small Renal Masses (4cm)

The number of people diagnosed with kidney cancer has doubled over the past 20 years, making it the eight most common cancer in the UK. Most tumours are less than 4cm in size, but over 80% of these are malignant (cancerous) and if left untreated, will slowly grow and spread. Current standard treatment for these small kidney cancers is to remove the diseased part of the kidney in an operation called a partial nephrectomy, but this can be quite a difficult operation. Because of the small tumour size and difficulties with the operation, other treatments have been developed to destroy the tumours. These treatments include radiofrequency ablation, which means that the tumour is destroyed by heat, and cryoablation, which means that the tumour is frozen and destroyed. Although removing the part of the diseased kidney in an operation is the tried and tested way to treat the kidney cancer, it does have risks and complications, such as bleeding. The other two treatments are less intrusive to the patient, and are less complicated as they do not require such a large operation as having part of the kidney removed, but it is not known if they are as good at destroying all of the tumour, and whether or not patients who have their tumour destroyed with these new methods require further treatment in future. In this study, the investigators are trying to determine if a large-scale study comparing these treatments is possible which is why this is called a feasibility study. The investigators are also looking at whether patients would be willing to be randomly assigned to a treatment group. The results of this study will then be compared to see how effective each of the treatments were and whether the number of patients who were happy to be randomly assigned to a treatment could be used to determine the number of patients required in a large-scale trial.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* Age greater than or equal to 18 years
* ASA physical status classification system of 1 or 2
* Radiological confirmation of (\>20 Hounsfield Unit) enhancing renal mass (\< 4cm) or biopsy proven renal cancer
* CT abdomen/chest/pelvis with no enlarged nodes or distant metastases
* Patient has provided written informed consent for participation in the study prior to any study specific procedures

Exclusion Criteria:

* Coagulopathy
* Concomitant disease that would render the patient unsuitable for the study
* Presence of urosepsis
* Cancer which is completely buried in the kidney
* More than one small renal cancer mass
* Previous participation in this study
* Inability to give informed consent; carer/proxy assent will not be allowed in this study