Abstract
The aim of the present study was to evaluate the safety and efficacy of computed tomography (CT)-guided percutaneous microwave ablation (MWA) of renal cell carcinoma (RCC) along with identifying prognostic factors affecting the progression survival rate. Institutional database retrospective research identified 69 patients with a biopsy proven solitary T1a (82.6%) or TIb (17.4%) RCC who have underwent percutaneous CT-guided MWA. Kaplan–Meier survival estimates for events were graphed and Cox regression analysis was conducted. Mean patient age was 70.4 ± 11.5 years. Mean size of the lesions was 3 ± 1.3 cm. Mean follow up time was 35.6 months (SD = 21.1). The mean progression free survival time from last ablation was 84.2 months. For T1a tumors, the cumulative progression free survival rate for 1, 6, 12 and 36 months were 100% (SE = 0%), 91.2% (SE = 3.7%), 91.2% (SE = 3.7%) and 87.5% (SE = 4.4%); the recurrence free survival rate for T1a RCC was 94.9%. For T1b tumors, the cumulative progression free survival rate for 1, 6, 12 and 36 months were 100% (SE = 0%), 63.6% (SE = 14.5%), 63.6% (SE = 14.5%) and 63.6% (SE = 14.5%). Grade 1 complications were recorded in 5 (7.2%) patients. Significantly greater hazard for progression was found in cases with a tumor size > 4 cm (HR = 9.09, p = 0.048). No statistically important difference regarding tumor progression was recorded between T1a tumors with a diameter ≤3 cm and >3 cm. In summary, the results of the present study show that CT guided percutaneous MWA is an effective technique for treatment of T1a renal cell carcinomas, irrespective of tumor size. T1b tumors were associated with higher progression rates.
Highlights
Introduction iationsRenal resection on terms of either radical or partial nephrectomy is a well-established local cure for the management of stage T1a and T1b renal cell carcinoma (RCC) [1,2,3,4,5,6,7,8]
Percutaneous ablation is a nephron-sparing technique with similar metastasis-free survival and cancer-specific survival rates when compared to partial nephrectomy, with additional benefits of a shorter hospitalization and recovery time [9]
The purpose of the present study is to evaluate the safety and efficacy of computed tomography-guided percutaneous microwave ablation (MWA) of renal cell carcinoma (RCC), along with identifying prognostic factors affecting the progression survival rate
Summary
Introduction iationsRenal resection on terms of either radical or partial nephrectomy is a well-established local cure for the management of stage T1a and T1b RCC [1,2,3,4,5,6,7,8]. The advancement and the effective application of percutaneous ablation techniques in overall cancer care render them an efficient alternative and an attractive solution in the treatment of RCC. Percutaneous ablation is a nephron-sparing technique with similar metastasis-free survival and cancer-specific survival rates when compared to partial nephrectomy, with additional benefits of a shorter hospitalization and recovery time [9]. Alam et al has reported that throughout a 7 years follow-up period, percutaneous ablation, radical or partial nephrectomy resulted in almost a 100% cancer-specific survival rate without any difference between the three treatment arms [10]. International guidelines advocate application of percutaneous ablation for RCC as an alternative therapeutic option for the management of Licensee MDPI, Basel, Switzerland.
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