Metastatic Kidney Cancer Ablation: 68.5% 10-Year Survival at UCLA

Thermal ablation for metastatic kidney cancer is a needle procedure: guided by CT or ultrasound, a doctor places a thin probe into a metastasis and destroys it with heat or cold. It is mainly offered to people with "oligometastatic" kidney cancer, meaning only a few metastases (up to five in this study). In a long-term UCLA analysis published in August 2026, 10-year overall survival among 50 patients was 68.5%, and local control at the treated sites was 87.6% at 10 years.

Over a mean follow-up of eight years, 64% of these patients never needed systemic therapy such as targeted drugs or immunotherapy. This article combines that study with the same team's 10-year results for microwave ablation of primary kidney cancer and explains who may be a candidate, the results, side effects and where it is available.

What is oligometastatic kidney cancer?

Renal cell carcinoma can spread to the lungs, bones, adrenal glands, liver or the other kidney. When it appears in only a few places rather than throughout the body, doctors call it oligometastatic disease. The UCLA study defined it as up to five measurable metastases.

In this setting, treating each metastasis directly with a local therapy is often considered. Kidney cancer frequently grows slowly, so removing a few metastases and then monitoring with regular scans has long been an accepted strategy. There are three main local options.

Based on a 2024 review in Future Oncology and the ESTRO consensus.

How the procedure works

The patient lies on a CT table while the doctor guides a needle-shaped probe through the skin into the center of the tumor. Cryoablation freezes the tip to destroy tumor cells; microwave and radiofrequency ablation heat the tip to destroy the tumor. Most procedures use sedation or general anesthesia, and the time depends on the number and location of tumors.

All three energy types were used in the UCLA study, and local control did not differ by energy type. The principle of heat ablation is explained in our RFA guide, and image-guided needle and catheter treatment in general in our IVR guide.

UCLA: 10-year results in 50 patients

A team led by Dr. Daniel H. Kim and Dr. Steven S. Raman of the UCLA Department of Radiological Sciences reviewed every patient who received percutaneous thermal ablation for oligometastatic kidney cancer between 2008 and 2019, with follow-up through 2023. The results appeared in August 2026 in the Journal of Vascular and Interventional Radiology (JVIR). Fifty patients (mean age 64.6) had 100 metastases treated in 91 procedures, with a mean follow-up of eight years.

Kim DH, et al. J Vasc Interv Radiol 2026, doi:10.1016/j.jvir.2026.109040. Local tumor progression-free survival is the share of treated sites where the tumor did not regrow.

Local control did not differ significantly by tumor size, metastasis location, histology (clear-cell versus other types) or energy used. The authors concluded that ablation provided durable local control and favorable long-term survival.

64% delayed systemic therapy

The figure that stands out is 64%: about two in three patients lived through a mean of eight years without targeted drugs or immunotherapy. Systemic treatments work well, but side effects such as fatigue, diarrhea, high blood pressure and skin reactions can last a long time.

The authors suggested ablation may help delay systemic therapy until it is most needed. If a new metastasis appears, it can be treated again, or systemic therapy can begin at that point. The study included carefully selected patients, so the results do not apply automatically to everyone with metastases.

10-year microwave results for primary kidney cancer

In the same month, the UCLA team also published in JVIR the results of microwave ablation for biopsy-proven primary T1 kidney cancer. Between 2013 and 2017, 86 tumors in 81 patients were treated, with a median follow-up of 76.8 months.

Kim DH, et al. J Vasc Interv Radiol 2026;37(11):109035. Tumors larger than 4 cm (T1b) had lower 8-year local control than T1a tumors.

Stable kidney function matters especially for people with one kidney or reduced kidney function. Results of cryoablation for small kidney cancer are covered in Kidney cancer cryoablation: long-term results.

Side effects and how they are managed

Of the 91 procedures for metastases, 9 (9.9%) had adverse events, and there were no procedure-related deaths. The main events were pneumothorax (air leaking from the lung) and pleural effusion (fluid around the lung); all resolved with observation or a chest tube.

Based on the UCLA paper and AuntMinnie coverage. Side effects vary with metastasis location.

Lung procedures and pneumothorax care are described in our lung cancer RFA guide, and ablation for bone metastases in bone metastasis pain ablation.

Who may be a candidate

• Few metastases: the study included up to five measurable metastases.
• Safe needle access: the tumor should be away from large vessels, bowel and nerves. Depending on location, SABR or surgery may suit better.
• Wish to delay systemic therapy: for slow-growing metastases, local treatment can buy time.
• Oligoprogression: when most metastases are controlled by drugs but one or two grow, treating only those sites can be considered.

The 2024 Lancet Oncology consensus from the European Society for Radiotherapy and Oncology (ESTRO), endorsed by the European Association of Urology (EAU), did not restrict local treatment by age or histology and considered concurrent immune checkpoint inhibitors acceptable. It named SABR as the preferred option for bone and adrenal metastases. The choice is made jointly by urology, medical oncology, radiology and radiation oncology. See also RFA results by cancer type.

Availability in Japan and abroad

International patients are often not covered by local public insurance, so confirm costs and scheduling directly with the hospital.

For a consultation abroad, prepare chest and abdominal contrast CT or MRI from the past three months, a bone scan or PET-CT, the pathology report from your original surgery (histology and grade) and your drug treatment history. A table listing the size and location of each metastasis speeds up the review.

Questions to ask your doctor

• Given the number and location of my metastases, is ablation, SABR or surgery the best fit?
• Which energy (cryo, microwave or RF) will you use, and why?
• How many tumors can be treated in one session, and how long is the hospital stay?
• When should I pause and restart my current medicines around the procedure?
• When is the follow-up CT, and what is the plan if a new metastasis appears?

For consultation preparation, see also Five questions before an RFA consultation.

Frequently asked questions

My kidney cancer has spread to the lung. Can it be treated with ablation?

If there are few metastases and the needle can reach them safely, you may be a candidate. Since pneumothorax and pleural effusion were the main side effects in the UCLA study, a hospital experienced in chest procedures is a good choice.

Does ablation mean I will not need medication?

In the UCLA study, 64% went without systemic therapy over a mean of eight years. New metastases are treated again or with drugs, so regular scans remain essential.

Is cryoablation or radiofrequency ablation better?

The UCLA study found no significant difference in local control by energy type. The choice depends on tumor location, size and the hospital's experience.

When can I return to daily life?

With no incision, the stay is usually one to a few days, and light daily activities can resume soon after discharge. A chest tube for pneumothorax may add a few days, so ask in advance.

This article summarizes overseas official sources and papers as general information and is not medical advice. Please discuss treatment choices with a doctor who has examined you.