MP09-17 EFFICACY AND SAFETY OF CT-GUIDED MICROWAVE ABLATION IN PATIENTS WITH LOCALIZED SMALL RENAL MASSES

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP09-17 EFFICACY AND SAFETY OF CT-GUIDED MICROWAVE ABLATION IN PATIENTS WITH LOCALIZED SMALL RENAL MASSES Shivani Jain, Ashley Foret, Chelsea Baumgartner, Megan Escott, Benjamin Henderson, Sean O'Brien, Scott Delacroix, Jessie Gills, and Mary Westerman Shivani JainShivani Jain More articles by this author , Ashley ForetAshley Foret More articles by this author , Chelsea BaumgartnerChelsea Baumgartner More articles by this author , Megan EscottMegan Escott More articles by this author , Benjamin HendersonBenjamin Henderson More articles by this author , Sean O'BrienSean O'Brien More articles by this author , Scott DelacroixScott Delacroix More articles by this author , Jessie GillsJessie Gills More articles by this author , and Mary WestermanMary Westerman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003224.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: CT-guided microwave ablation (MWA) is increasingly used for the treatment of localized small renal masses, especially in patients with co-morbidities that increase the risks of traditional nephrectomy. The main advantages of a percutaneous ablative approach over surgery include less invasiveness and lower reported complication rates. We report patient characteristics and outcomes following MWA of clinically localized small renal masses. METHODS: A retrospective chart review of our institution’s biopsy database was conducted to identify all patients with clinically localized renal masses 3 cm or less on abdominal imaging and who underwent a subsequent renal mass biopsy (RMB) and MWA between the years of 2012 and 2022. RESULTS: 135 patients met inclusion criteria. MWA was technically successful in 98.4% of patients. The majority of patients were male (59.9%) and Caucasian (82.5%). Median (IQR) tumor size was 2.2 cm (0.7,3). The median (IQR) for age and BMI was 70 (38,94) and 30.7 (15.0,52.7), respectively. These parameters for MWA ablation time in minutes and watts were 10 (1,20) and 65 (65,140), respectively. 36% of lesions biopsied were benign oncocytomas. In those with biopsy-proven clear cell RCC, 4.3% of patients had complications following MWA. Complications requiring readmission, albeit rare, included urosepsis, lung collapse, and retroperitoneal hematoma. Renal function was conserved in all except 2 patients. Local recurrence requiring repeat ablation (4, 3.27%) or surgery (partial nephrectomy (2, 1.64%), radical nephrectomy (5, 4.10%) was rare. Metastatic-free survival was 95.6% at 24 months for patients who underwent MWA (95% CI 93.4 – 98.7). CONCLUSIONS: In this retrospective review of renal masses 3 cm or less that subsequently underwent RMB and MWA, procedural complication requiring admission or readmission was rare. Local control rates were 98.3% for cT1a malignancies. Complication and local control rates found in this large contemporary study are lower than those reported in previously published data. A majority of research on thermal ablation for renal masses focuses on cryoablation and RFA, and AUA 2021 guidelines on renal mass evaluation and management consider MWA an investigational technique. Nonetheless, MWA has potential advantages of higher ablation volume and shorter ablation time compared against other thermal techniques. MWA for renal masses 3 cm or less should be further investigated as a safe and efficacious option for patients who have co-morbidities that increase the risk of surgical complications. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e112 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shivani Jain More articles by this author Ashley Foret More articles by this author Chelsea Baumgartner More articles by this author Megan Escott More articles by this author Benjamin Henderson More articles by this author Sean O'Brien More articles by this author Scott Delacroix More articles by this author Jessie Gills More articles by this author Mary Westerman More articles by this author Expand All Advertisement PDF downloadLoading ...