Oncologic Outcomes of Microwave Ablation of Biopsy-Proven cT1a Renal Cell Carcinomas.
Academic Article
Overview
abstract
PURPOSE: Evaluate oncologic outcomes for biopsy-proven cT1a renal cell carcinoma (RCC) treated with CT-guided microwave ablation (MWA). MATERIALS AND METHODS: Patients who underwent MWA from 2015-2022 for cT1a RCCs were retrospectively reviewed. Inclusion criteria included tumors less than 4 cm (T1a) and a pathologic diagnosis of RCC. Exclusion criteria included non-RCC pathologies, RCCs larger than 4.0 cm, prior ablations, and known RCC syndromes. Post-ablation surveillance imaging occurred immediately in the procedure suite, at three months, and annually thereafter. Outcomes included local tumor progression and primary and secondary treatment efficacy. Kaplan-Meier survival analyses were conducted, including local progression-free survival and all-cause mortality. RESULTS: 206 patients met inclusion criteria. Median (IQR) tumor size was 2.1 (1.6-2.7) cm with median follow-up time of 27.0 (14.8-45.3) months. Six patients (2.9%) experienced disease progression after a median of 22.5 (16.3, 34.0) months. Primary and secondary treatment efficacies were 94.7% and 97%. Two patients (1.0%) developed metastases. At 24 months, freedom from local tumor progression, disease progression, and metastasis was 91.5%, cancer-specific survival was 100%, and all-cause mortality rate was 4.9%. The adverse event (AE) rate was 3.3%. Four (1.9%) AEs with Common Terminology Criteria for Adverse Events (CTCAE) were Grade III or higher, including one case of ipsilateral ureteral obstruction requiring temporary stenting and two perinephric hematomas requiring intervention with angiogram (n=1, 0.4%) or embolization (n=1, 0.4%). CONCLUSION: MWA is a safe and efficacious treatment for patients with cT1a RCCs.
