Percutaneous Microwave Ablation of Stage T1b Renal Cell Carcinoma: Short-Term Assessment of Technical Feasibility, Short-Term Oncologic Outcomes, and Safety

Abstract

Purpose: To report on the safety, technical results, and oncologic outcomes of computed tomography guided percutaneous microwave ablation of stage cT1b renal cell carcinoma. Materials and Methods: This single-center retrospective study investigated consecutive patients with T1b renal cell carcinoma who were treated with CT guided percutaneous microwave ablation between December 2015 and May 2019. Patient baseline characteristics, tumor biologic features, technical parameters, clinical outcomes, and complications were recorded and evaluated. Local tumor progression-free survival and overall survival rates were estimated using the Kaplan-Meier methods. Results: This study included 23 patients (18 men [mean agestandard deviation, 74.6 years-10.2; range 58-89 years] and 5 women [mean age, 71.6 years-10.1; range 62-86 years]; overall mean age, 74.0 years-10.0; range 58-89 years) with 23 T1b renal cell carcinomas. Primary technical success was achieved in 20/23 (87%) patients. Secondary technical success was achieved in 3/3 (100%) patients. Local tumor progression-free survival was 100.0%, 90.9%, and 90.9% at 1, 2, and 3 years, respectively. Overall survival was 95.2%, 85.7%, and 71.4% at 1, 2, and 3 years, respectively. There were 2 (8.7%) complications; both were classified as minor complications according to the Society of Interventional Radiology grading system. Conclusions: Computed tomography guided percutaneous microwave ablation for T1b renal cell carcinoma is associated with high rates of technical success, excellent local tumor progression-free survival, short-term survival and overall survival, and low complication rates.

Local recurrence and other oncologic outcomes after percutaneous image-guided tumor ablations on stageT1b renal cell carcinoma: a systematic review and network meta-analysis

“…CA appeared to be the most used ablation tool with 6/9 studies and 204/311 (66%) patients. Only Shapiro et al [12] and Guo et al [15] reported results with MWA.…”

“…MWA relies on the continuous realignment of polar molecules (primarily water) with the oscillating microwave field, increasing kinetic energy and tissue temperature [30,31]. Two included studies used microwaves: Shapiro et al [12] and Guo et al [15]. Sixty-three patients received this treatment.…”

“…Apart from three studies (Hebbadj et al [14], Guo et al [15] and Gunn et al [17]), all authors studied the progression to metastatic disease. Results varied from 0/40 [10] to 9.5% [10].…”

“…All reviewed articles, except Andrews et al [16], described adverse effects following ablation. Most articles used the Clavien-Dindo ranking system [23], although Gunn et al [17] used CIRSE classification [22], Guo et al [15] and Takaki et al [10] divided complications into minor and major adverse effects. It is possible, to sum up, those adverse effects by pooling them into minor and major adverse effects.…”

“…International guidelines recommended surgery (radical nephrectomy (RN) or partial nephrectomy (PN)) as the best treatment for T1b RCC (4 tumor 7 cm) [9]. However, thermal ablation of T1b RCC has been published with good results recently [8,[10][11][12][13][14][15][16][17][18].…”