Mid-to-long term oncologic and functional outcomes of zero ischemia laparoscopic microwave ablation-assisted tumor enucleation for renal cell carcinoma: a single-center experience.

Abstract

BackgroundZero ischemia laparoscopic microwave ablation assisted tumor enucleation (MWA-TE) has been applied to renal cell carcinoma (RCC) treatment, but the mid-to-long term follow-up results are lacking. This study aims to evaluate the mid-to-long term oncological and functional consequences of MWA-TE in RCC treatment.MethodsWe conducted a retrospective analysis of 278 patients who received zero ischemia laparoscopic MWA-TE for RCC from March 2013 to June 2017. Peri- and post-operative data, renal functional and oncologic results were accumulated and evaluated.ResultsThe median length of operation was 86 min, with an approximate median blood loss of 50 mL. The median estimated glomerular filtration rate (eGFR) prior to and 3 months post-operation was 90.6 [interquartile range (IQR), 65.2–116.0] and 83.6 (IQR, 52.4–114.8) mL/min/1.73 m2, the median eGFR of the latest follow-up was 87.4 (IQR, 67.7–107.1) mL/min/1.73 m2 and paired t-tests showed no significant difference between preoperative, post-operative and latest eGFR (P=0.069 and P=0.071). The median change in eGFR from before surgery to the latest follow-up was −2.82 mL/min/1.73 m2. The median follow-up period was 39 months, and among all the patients, nine reported cancer recurrence or metastasis, the 3- and 5-year overall survival (OS) was 99.6% and 98.4%, respectively, and recurrence-free survival (RFS) was 98.2% and 95.8%, respectively.ConclusionsZero ischemia laparoscopic MWA-TE is considered a feasible and effective nephron sparing surgical technique for selected renal tumors, and is accompanied by a low perioperative complication rate and promising mid-to-long term oncological and functional outcomes.