Thermal ablation of the small renal mass: a critical analysis of current literature

Mershon, J. Patrick; Tuong, Mei; Schenkman, Noah S.

doi:10.23736/s0393-2249.19.03572-0

Cited by 28 publications

(8 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Comparisons of ablative techniques (RFA, CA and MWA) suggest equivalent recurrence‐free survival (RFS), CSS, overall survival (OS), and complications [15–18]. MWA typically offers shorter ablation times and reduced peri‐procedural sedative requirements [19]; however, it is described less frequently in academic literature and with small patient numbers.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous microwave ablation of renal masses in a UK cohort

et al. 2020

View full text Add to dashboard Cite

Objectives To report a tertiary referral centre’s experience of microwave ablation (MWA) for suspected renal cell carcinoma (RCC), describing complications and oncological outcomes. Patients and Methods Consecutive MWA procedures (n = 113) for renal masses (October 2016 to September 2019) were maintained on a prospective database. Data describing patient, disease, procedure, complications, and oncological outcomes were analysed. Results The median (range) age was 68 (33–85) years, 73% were male, and the median Charlson Comorbidity Index was 0. The median (interquartile range [IQR]) tumour diameter was 25 (20–32) mm. In all, 95% had renal mass biopsy, with histologically confirmed cancer in 75%. The median (IQR) R.E.N.A.L. (Radius, Exophytic/Endophytic, Nearness, Anterior/Posterior, Location) nephrometry score was 7 (6–8). The median ablation time was 6 min and length of stay was 1 day for 95% of the patients. Clavien–Dindo complication Grades I, II, IIIb and IV occurred in 18%, 1.8%, 0.9% and 0.9%, respectively. The median follow‐up was 12 months and the median (IQR) renal function change was −4 (−18 to 0)%. One patient (0.9%) had local recurrence, treated with re‐ablation; two developed metastatic progression; and two (1.8%) had indeterminate findings on follow‐up (one lung nodule and one possible local recurrence), managed with ongoing protocolised computed tomography surveillance. Post‐procedure complications were associated with total ablation time (odds ratio [OR] 1.152/min, 95% confidence interval [CI] 1.040–1.277) and total ablation energy (OR 1.017/kJ, 95% CI 1.001–1.033). Conclusions We describe the largest UK series of MWA treatment for T1a/small T1b renal masses to date. MWA was well tolerated, with 95% discharged the following day and low complication/re‐admission rates. Current follow‐up demonstrates favourable disease control. MWA appears to be safe and effective and should be considered in future prospective comparisons of treatments for T1a/small T1b renal masses.

show abstract

Section: Introductionmentioning

confidence: 99%

Percutaneous microwave ablation of renal masses in a UK cohort

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The surgical management of SRMs has developed over the years, with an emphasis on nephron-sparing and minimally invasive procedures. RaPN and focal therapy application in SRM treatment has recently gained popularity [ 10 ], and thermal ablation is indicated in patients with multiple tumours and/or unable and/or unwilling to undergo more invasive surgery [ 11 ]. The 2019 guideline of European Association of Urology mentioned mixed study reports of oncological outcomes, perioperative outcomes, complication rates, new CKD developments, and other QoL measures compared with cryoablation with partial nephrectomy [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Robot-Assisted Laparoscopic Partial Nephrectomy with Laparoscopic Cryoablation in the Treatment of Localised Renal Tumours: A Propensity Score-Matched Comparison of Long-Term Outcomes

et al. 2021

View full text Add to dashboard Cite

Preserving renal function and controlling oncological outcomes are pertinent when managing renal neoplasms. Cryoablation is the recommended treatment only for clinical T1a stage renal tumour. Here, we compared the outcomes of robot-assisted laparoscopic partial nephrectomy (RaPN) and laparoscopic cryoablation (LCA) in the treatment of patients with localised T1-T2 renal tumours. Overall, 86 patients who received RaPN and 78 patients underwent LCA were included in this study. The intraoperative, postoperative, and oncological outcomes in the LCA group were non-inferior to the RaPN group. Moreover, LCA demonstrated shorter operative time (267.45 ± 104.53 min vs. 138.56 ± 45.28 min, p < 0.001), lower blood loss (300.56 ± 360.73 mL vs. 30.73 ± 50.31 mL, p < 0.001), and slight renal function deterioration because of the reduced invasiveness, without compromising on the oncological outcomes.

show abstract

“…Mershon JP et al. summarized the oncologic outcomes, complication rates, procedural differences and renal function of cryoablation, radiofrequency ablation, and microwave ablation as management strategy for small renal masses ( 28 ). Similar with other ablative techniques, cryoablation is a safe and effective management option for small renal masses in select patients, particularly in those with multiple tumors and/or those unable or unwilling to undergo more invasive surgery.…”

Section: Discussionmentioning

confidence: 99%

Survival in Metastatic Renal Cell Carcinoma Patients Treated With Sunitinib With or Without Cryoablation

Wang

Zhang

et al. 2021

Front. Oncol.

View full text Add to dashboard Cite

BackgroundPercutaneous cryoablation (PCA) has emerged as an alternative to extirpative management of small renal masses in select patients. In recent years, the use of targeted therapies has become mainstream, while the role of PCA in treating primary tumor is not well established among patients with metastatic renal cell carcinoma (mRCC). We sought to evaluate how mRCC patients react to PCA in combination with sunitinib.MethodsWe retrospectively identified patients with mRCC (primary tumor diameter ≤ 7 cm) treated with sunitinib between 2013 and 2019. These patients were categorized by initial treatment (cryoablation followed by sunitinib versus sunitinib only). Oncological outcomes and rate of adverse events were compared.ResultsOf the 178 patients analyzed, 65 underwent PCA prior to sunitinib. The median overall survival (OS) in the PCA-sunitinib group was 31.7 months (95% CI; 26.1-37.3), better than the sunitinib-only group, which reported a median OS of 19.8 months (95% CI; 17.1-22.4) (p < 0.001). The median progression-free survival (PFS) in patients treated with PCA-sunitinib versus sunitinib alone was 13.8 months (95% CI; 10.0-17.6) versus 7.2 months (95% CI: 6.1-8.3) (p < 0.005). No significant differences in adverse events were observed (p > 0.05).ConclusionsPCA combined with sunitinib is associated with better survival outcomes than sunitinib alone in patients with mRCC. Careful patient selection remains warranted. These results should inform future prospective trials.

show abstract

Thermal ablation of the small renal mass: a critical analysis of current literature

Cited by 28 publications

References 50 publications

Percutaneous microwave ablation of renal masses in a UK cohort

Percutaneous microwave ablation of renal masses in a UK cohort

Comparison of Robot-Assisted Laparoscopic Partial Nephrectomy with Laparoscopic Cryoablation in the Treatment of Localised Renal Tumours: A Propensity Score-Matched Comparison of Long-Term Outcomes

Survival in Metastatic Renal Cell Carcinoma Patients Treated With Sunitinib With or Without Cryoablation

Contact Info

Product

Resources

About