PD40-06 COMPARING ONCOLOGIC OUTCOMES BETWEEN SURGERY AND MICROWAVE ABLATION FOR RENAL MASSES BETWEEN 3 AND 7 CM

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD40-06 COMPARING ONCOLOGIC OUTCOMES BETWEEN SURGERY AND MICROWAVE ABLATION FOR RENAL MASSES BETWEEN 3 AND 7 CM Arighno Das, Daniel Shapiro, Tudor Borza, Shane Wells, Louis Hinshaw, Timothy Ziemlewicz, Paul Laeseke, Fred Lee, Stephen Nakada, and E. Jason Abel Arighno DasArighno Das More articles by this author , Daniel ShapiroDaniel Shapiro More articles by this author , Tudor BorzaTudor Borza More articles by this author , Shane WellsShane Wells More articles by this author , Louis HinshawLouis Hinshaw More articles by this author , Timothy ZiemlewiczTimothy Ziemlewicz More articles by this author , Paul LaesekePaul Laeseke More articles by this author , Fred LeeFred Lee More articles by this author , Stephen NakadaStephen Nakada More articles by this author , and E. Jason AbelE. Jason Abel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003345.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Current AUA guidelines recommend radiofrequency ablation (RFA) or cryoablation be considered only for renal masses <3 cm. However, microwave ablation (MWA) reliably generates larger ablation zones compared to other ablation modalities. This study compared oncologic outcomes between surgery and MWA in patients with renal masses between 3 and 7 cm. METHODS: Data was analyzed for consecutive patients with 3 to 7 cm renal cell carcinoma (RCC) treated with MWA, radical nephrectomy (RN), or partial nephrectomy (PN), excluding patients with metastases or tumor thrombus. Local recurrence-free, metastasis-free, and cancer-specific survival were estimated using Kaplan-Meier method. Variables associated with survival were determined using Cox proportional hazard models. RESULTS: Of 732 patients, 160 (22%) underwent MWA, 184 (25%) underwent PN, and 392 (53%) underwent RN (Table 1). Patients treated with MWA were older and more comorbid (p<0.001). Patients who underwent RN had larger tumors (p<0.001) and higher nuclear grade (p<0.001). Median follow-up was 40, 41, and 44 months following MWA, PN, and RN (p=0.4). 5-year local recurrence free survival was lower for MWA (86%) compared to PN (98%) and RN (98%) (p<0.0001). No differences were noted in metastasis-free or cancer-specific survival between the three cohorts (p=0.13 and p=0.85). Adjusting for age, pathology, radiologic size, and nuclear grade, MWA was associated with similar metastasis-free and cancer-specific survival compared to surgery (Table 2).Of 18 patients with local recurrence following MWA (11%), 13 underwent repeat ablation, 3 pursued surveillance, 1 had stereotactic radiation, and 1 underwent nephrectomy. After 2nd ablation, 12/13 (92%) patients had no recurrence of disease at median 19 months. CONCLUSIONS: Microwave ablation for 3 to 7 cm renal cell cancer has higher rates of local recurrence, which may be salvaged by repeat treatment. There was no difference in metastatic progression or cancer specific survival compared to surgery. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1053 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Arighno Das More articles by this author Daniel Shapiro More articles by this author Tudor Borza More articles by this author Shane Wells More articles by this author Louis Hinshaw More articles by this author Timothy Ziemlewicz More articles by this author Paul Laeseke More articles by this author Fred Lee More articles by this author Stephen Nakada More articles by this author E. Jason Abel More articles by this author Expand All Advertisement PDF downloadLoading ...