Percutaneous microwave ablation for local control of metastatic renal cell carcinoma

Maciolek, Kimberly A.; Abel, E. Jason; Best, Sara L.; Emamekhoo, Hamid; Averill, Sarah; Ziemlewicz, Timothy J.; Lubner, Meghan G.; Hinshaw, J. Louis; Lee, Fred T.; Wells, Shane A.

doi:10.1007/s00261-018-1498-z

Cited by 11 publications

(7 citation statements)

References 31 publications

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“…This is in keeping with various retrospective studies, which highlight a potential benefit of this treatment strategy [ 71 , 101 , 102 ]. Metastasis-directed ablation may enable the ongoing systemic therapy to be used for longer and avoid the need to change systemic therapies where second-line or third-line therapies may be less effective and have more adverse effects.…”

Section: Discussionsupporting

confidence: 88%

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Beyond the Knife in Renal Cell Carcinoma: A Systematic Review—To Ablate or Not to Ablate?

Green

Taylor

Khoo

2023

Cancers

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Intensified systemic therapy in metastatic renal cell carcinoma (mRCC) has led to improved patient outcomes. Patients commonly require local control of one or a few metastases. The aim was to evaluate metastasis-directed ablative therapies in extracranial mRCC. Two databases and one registry were searched, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach, for all prospective and matched-pair case–control mRCC studies of radiofrequency ablation (RFA), cryotherapy, microwave ablation (MWA), and stereotactic body radiotherapy (SBRT). Eighteen studies were identified. Fourteen investigated SBRT in 424 patients. Four thermal ablation studies were identified: two cryotherapy (56 patients) and two RFA studies (90 patients). The median participant number was 30 (range 12–69). The combined median follow-up was 17.3 months (range 8–52). Four SBRT studies reported local control (LC) at 12 months, median 84.4% (range 82.5–93). Seven studies (six SBRT and one cryotherapy) reported an LC rate of median 97% (79–100%). Median overall survival (OS) was reported in eight studies (five SBRT, two cryotherapy, and one RFA) with a median of 22.7 months (range 6.7–not reached). Median progression-free survival was reported in seven studies (five SBRT, one cryotherapy, and one RFA); the median was 9.3 months (range 3.0–22.7 months). Grade ≥3 toxicity ranged from 1.7% to 10%. SBRT has excellent local control outcomes and acceptable toxicity. Only four eligible thermal ablative studies were identified and could not be compared with SBRT. Translationally rich definitive studies are warranted.

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Section: Discussionsupporting

confidence: 88%

“…There are existing data to support the low toxicity profiles of local ablative therapies inclusive of SBRT [ 37 , 38 ], RFA [ 40 , 69 , 70 ], and cryotherapy [ 26 , 71 ]. This review further supports this opinion.…”

Section: Discussionmentioning

confidence: 99%

Beyond the Knife in Renal Cell Carcinoma: A Systematic Review—To Ablate or Not to Ablate?

Green

Taylor

Khoo

2023

Cancers

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“…Compared with radiofrequency ablation (RFA), MWA is related to several speculative benefits, including a shorter operation time, a larger ablation volume, a higher intratumoral temperature, and less reliance on the electrical conductivities of tissues, showing comparable efficacy to hepatic resection. In recent years, image-guided thermal ablation has been utilized to treat several metastatic tumors [11][12][13]. However, studies on OCLM that accept thermal ablation are rare.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous microwave ablation versus surgical resection for ovarian cancer liver metastasis

Zhuo

Zhou

Ruan

et al. 2020

International Journal of Hyperthermia

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Objective: To compare the oncological outcomes between microwave ablation (MWA) and surgical resection (SR) in patients with ovarian cancer liver metastasis (OCLM). Materials and methods: In this retrospective study, a total of 29 female patients (mean age, 47.8 ± 12.9 years; range, 21-65 years) diagnosed with forty-three OCLM nodules between September 2008 and July 2016 were included. All patients with ovarian cancer received chemotherapy and cytoreductive surgery (CRS). Fifteen patients with 22 nodules underwent MWA, and 14 patients with 21 nodules underwent SR. Overall survival (OS), local tumor recurrence-free survival (LTRS), and operationrelated parameters were compared between the two groups. Multivariate analyses were performed on clinicopathological variables to identify factors affecting OS and LTRS. Results: The median follow-up time was 70.2 months (range, 12.1-107.2 months). Fourteen patients died during this period. The 1-, 3-, and 5-year OS and LTRS rates after MWA were comparable to those after SR (p ¼ .198 and p ¼ .889, respectively). Compared with the SR group, the MWA group had a shorter surgical time (p < .001), less estimated blood loss (p < .001), shorter postoperative hospitalization (p < .001) and fewer costs (p ¼ .015). The multivariate analysis showed that old age (p ¼ .001) was a predictor of poor OS and that intrahepatic tumor size (p ¼ .005) and intrahepatic tumor number (p ¼ .001) were predictors of poor LTRS. Conclusion: Percutaneous MWA had comparable oncologic outcomes with those of SR and could be a safe and effective treatment for OCLM.

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“…Percutaneous multisite cryoablation may address various anatomic sites under ultrasound- or CT-guidance and is cost-effective further to having only a 2% rate of complications or local recurrence ( 73 ). Microwave ablation is also safe with a 15% rate of complications and durable local control in 93% of cases, although retrospective nature and small study size remains a limitation ( 74 ).…”

Section: Local Therapies For Oligoprogressive Diseasementioning

confidence: 99%

Current Options for Second-Line Systemic Therapy in Metastatic Renal Cell Carcinoma

Mitsogiannis

Mitsogianni²,

Papathanassiou³

et al. 2022

jkcvhl

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Standard systemic therapy of advanced renal cell carcinoma (RCC) involves targeting angiogenesis, mainly through tyrosine kinase inhibitors (TKI) against the vascular endothelial growth factor receptor (VEGFR) pathway and targeting the immune checkpoints, namely, programmed death-1 (PD-1) or its ligand (PD-L1), and cytotoxic T-lymphocyte-associated protein 4 (CTLA4). With current strategies of combining these two approaches in the front-line setting, less is known about optimal selection of therapy upon development of resistance in the second and later lines of treatment for progressive disease. This review discusses currently available therapeutic options in patients who have progressive RCC after prior treatment with double immune checkpoint inhibitors (ICIs) or ICI-TKI combinations.

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Percutaneous microwave ablation for local control of metastatic renal cell carcinoma

Abstract: Microwave ablation of oligometastatic renal cell carcinoma is safe and provides durable local control in appropriately selected patients.

Cited by 11 publications

References 31 publications

Beyond the Knife in Renal Cell Carcinoma: A Systematic Review—To Ablate or Not to Ablate?

Beyond the Knife in Renal Cell Carcinoma: A Systematic Review—To Ablate or Not to Ablate?

Percutaneous microwave ablation versus surgical resection for ovarian cancer liver metastasis

Current Options for Second-Line Systemic Therapy in Metastatic Renal Cell Carcinoma

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