Percutaneous microwave ablation of renal cell carcinoma using a high power microwave system: focus upon safety and efficacy

Filippiadis, Dimitrios; Gkizas, Christos V; Chrysofos, M; Siatelis, Argyris; Velonakis, Georgios; Alexopoulou, Efthimia; Kelekis, Alexis; Brountzos, Elias; Kelekis, Nikolaos

doi:10.1080/02656736.2017.1408147

Cited by 25 publications

(18 citation statements)

References 41 publications

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“…High-power microwave equipment, with a generator frequency of 2.45 GHz and an internal fluid cooling system, provides a larger spherical ablation zone within shorter duration 21–23. MWA mechanism involves applying high-speed molecular friction that generates a persistently high temperature; this causes protein denaturation and coagulative necrosis of the tumor cells, resulting in the in situ inactivation of the tumor.…”

Section: Discussionmentioning

confidence: 99%

<p>Image-Guided Percutaneous ‎Microwave Ablation Versus Cryoablation For Hepatocellular Carcinoma In High-Risk Locations: Intermediate-Term Results</p>

Hu¹,

Chen

Wang³

et al. 2019

CMAR

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ObjectiveThe aims of this study were to compare the clinical outcomes between image-guided percutaneous microwave ablation (MWA) and cryoablation (CRA) in patients with hepatocellular carcinoma (HCC) in high-risk locations and to identify the prognostic factors associated with the two treatment methods.MethodsThis retrospective study was institutional review board approved. A total of 120 patients (88 men and 32 women) with one hundred and thirty-four HCC lesions in high-risk locations from April 2014 to March 2018 were reviewed. Sixty-four patients underwent MWA and 56 patients underwent CRA. Survival, recurrence and complications were compared between the two groups. Effect of changes in key outcomes (i.e., overall survival (OS), recurrence-free survival (RFS) and local tumor progression (LTP)) was statistically analyzed with the log rank test. Univariate and multivariate analysis were performed on clinicopathological variables to identify factors affecting intermediate-term outcomes.ResultsThe OS and RFS after MWA were comparable to those of CRA (P =0.141, and P=0.469, respectively). The LTP and major complication in MWA group was higher than those in CRA group (P=0.003, and P=0.039). Univariate analysis showed that age (P=0.007), tumor size (P=0.001), and Child-Turcotte-Pugh (CTP) grade (P=0.003) were risk factors for OS, and multivariate analysis results showed that older age (≥65 years) (P=0.002, HR:3.338, 95% CI:1.928–5.281), 3.0–5.0 cm in size (P<0.001, HR: 3.312, 95% CI: 1.872–4.489) and CTP grade B (P=0.001, HR:3.382, 95% CI: 1.882–5.902) were independently associated with poor OS.ConclusionCRA had comparable oncologic outcomes with MWA and could be a safe and effective treatment for HCC in high-risk locations.

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Section: Discussionmentioning

confidence: 99%

<p>Image-Guided Percutaneous ‎Microwave Ablation Versus Cryoablation For Hepatocellular Carcinoma In High-Risk Locations: Intermediate-Term Results</p>

Hu¹,

Chen

Wang³

et al. 2019

CMAR

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“…In comparison to CA, RFA costs less, procedure time is shorter and bleeding complication rate is lower, yet CA is less harmful to the renal collecting system [46,49,50]. Microwave-based techniques present practical advantages over radiofrequencies, but their more recent development is coupled with limited literature compared to RFA and CA, i.e., lack of mid-and long-term follow-up and RCT [12,51]. Available evidence on MWA in renal tumors suggests that MWA has a similar or slightly better technical efficacy rate and local tumor recurrence rate than RFA or CA with comparable complications rates and lower incidence of major complications [30].…”

Section: Comparing Different Ablation Techniquesmentioning

confidence: 99%

“…Available evidence on MWA in renal tumors suggests that MWA has a similar or slightly better technical efficacy rate and local tumor recurrence rate than RFA or CA with comparable complications rates and lower incidence of major complications [30]. In comparison to RFA, MWA procedure times are shorter and the procedure is less influenced by the heat-sink effect also providing larger ablation zones [43,46,51]. Advantages of CA include the ability to monitor ablation with imaging, the potential treatment of T1b RCCs and the treatment of centrally located or very close to vulnerable structures, such as the spinal column and the bowel, RCCs [46,52,53].…”

Section: Comparing Different Ablation Techniquesmentioning

confidence: 99%

Percutaneous ablation techniques for renal cell carcinoma: current status and future trends

Filippiadis

Mauri

Marra

et al. 2019

International Journal of Hyperthermia

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Percutaneous ablation is an increasingly applied technique for the treatment of localized renal tumors, especially for elderly or co-morbid patients, where co-morbidities increase the risk of traditional nephrectomy. Ablative techniques are technically suited for the treatment of tumors generally not exceeding 4 cm, which has been set as general consensus cutoff and is described as the upper threshold of T1a kidney tumors. This threshold cutoff is being challenged, but with still limited evidence. Percutaneous ablation techniques for the treatment of renal cell carcinoma (RCC) include radiofrequency ablation, cryoablation, laser or microwave ablation; the main advantage of all these techniques over surgery is less invasiveness, lower complication rates and better patient tolerability. Currently, international guidelines recommend percutaneous ablation either as intervention for frail patients or as a first line tool, provided that the tumor can be radically ablated. The purpose of this article is to describe the basic concepts of percutaneous ablation in the treatment of RCC. Controversies concerning techniques and products and the need for patient-centered tailored approaches during selection among the different techniques available will be discussed.

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“…Nine studies, including 552 lesions treated with MWA, were included (►Table 2). [54][55][56][57][58][59][60][61][62] All but one study pertained to percutaneous approach alone. Average lesion size was 2.8 cm.…”

Section: Review Of Contemporary Oncologic Outcomesmentioning

confidence: 99%

Systematic Review of Contemporary Evidence for the Management of T1 Renal Cell Carcinoma: What IRs Need to Know for Kidney Cancer Tumor Boards

Cronan

Dariushnia

Bercu

et al. 2019

Semin intervent Radiol

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Renal cell carcinoma is a relatively common malignancy, with 60 to 70 thousand cases a year in the United States alone. Increased utilization of cross-sectional imaging has led to an increase in the number of early renal cell cancers seen by the medical establishment. In addition, certain patient populations have an increased risk of developing kidney cancers which may mandate aggressive screening protocols. This article discusses the epidemiology of renal cell cancers; discusses the current management guidelines from multiple specialty societies; discusses some of the surgical and interventional techniques used in the treatment of such lesions; and provides a review of the literature regarding treatments of early-stage renal cell cancers.

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Percutaneous microwave ablation of renal cell carcinoma using a high power microwave system: focus upon safety and efficacy

Abstract: Percutaneous microwave ablation of RCC using a high power microwave system is a safe and efficacious technique for the treatment of small- to medium-sized renal masses.

Cited by 25 publications

References 41 publications

<p>Image-Guided Percutaneous ‎Microwave Ablation Versus Cryoablation For Hepatocellular Carcinoma In High-Risk Locations: Intermediate-Term Results</p>

<p>Image-Guided Percutaneous ‎Microwave Ablation Versus Cryoablation For Hepatocellular Carcinoma In High-Risk Locations: Intermediate-Term Results</p>

Percutaneous ablation techniques for renal cell carcinoma: current status and future trends

Systematic Review of Contemporary Evidence for the Management of T1 Renal Cell Carcinoma: What IRs Need to Know for Kidney Cancer Tumor Boards

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