Editing Management of Localized and Locally Advanced Disease (section)

==== Technology ====
* '''RFA'''
** Utilizes high frequency alternating current (460-500 kHz) to induce ion agitation and frictional heating in adjacent tissue
*** Can be achieved through 2 types of radiofrequency generator systems:
***# Temperature-based system: drives the current to reach a target temperature
***# Impedance-based systems: continue ablation until a predetermined impedance level is reached.
* '''Cryoablation'''
** Generates lethal temperatures below -20 to -40 °C, resulting in coagulative tissue necrosis
** '''Volume of lethal temperature generated during cryoablation is regulated by (4):'''
**# '''Duration of freezing'''
**# '''Number of freeze cycles'''
**#* '''<span style="color:#ff0000">Double freeze results in larger volumes of renal tissue necrosis, compared to single freeze</span>'''
**# '''Size and number of cryoprobes'''
**# '''Local tissue interactions'''
** '''<span style="color:#ff0000">Complete treatment of a tumour requires that the iceball extend beyond the tumor</span>''' because the peripheral leading edge of the iceball is at sub-lethal temperatures
*** Lethal temperatures are reached approximately 5 mm from the periphery of the iceball; '''<span style="color:#ff0000">the ice-ball is usually extended ≈1 cm beyond the edge of the tumor</span>'''
*'''Both radiofrequency ablation and cryoablation may be offered as options[https://pubmed.ncbi.nlm.nih.gov/28479239/]'''
*Other new technologies, such as high-intensity focused ultrasound and image-guided radiosurgical treatments (SBRT), are under development and may allow extracorporeal treatment of small renal tumors in the future