The effect of tumor size and location on efficacy and safety of US- and CT- guided percutaneous microwave ablation in renal cell carcinomas

• Published in: Abdominal imaging 2019-06, Vol.44 (6), p.2308-2315
• Main Authors: Shakeri, Sepideh, Afshari Mirak, Sohrab, Mohammadian Bajgiran, Amirhossein, Pantuck, Allan, Sisk, Anthony, Ahuja, Preeti, Lu, David S., Raman, Steven S.
• Format: Article
• Language: English
• Subjects: ABLATION; BIOPSY; Bladder; Cancer; CARCINOMAS; Clear cell-type renal cell carcinoma; Complications; COMPUTERIZED TOMOGRAPHY; Data collection; Demographics; Demography; Epidermal growth factor receptors; Gastroenterology; Hematoma; HEMATOMAS; Hepatology; Imaging; Kidney cancer; KIDNEYS; Lesions; Medicine; Medicine & Public Health; Microwave ablation; MICROWAVE RADIATION; PAIN; PATIENTS; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; Renal function; Retroperitoneum; Safety; Success; Survival; Tumors; Ureters
• ISSN: 2366-004X; 2366-0058; 2366-0058
• DOI: 10.1007/s00261-019-01967-8

Purpose To evaluate the effect of size and central location of the tumor on safety and efficacy of percutaneous CEUS- and CT-guided MWA in biopsy-proven renal cell carcinomas (RCCs). Materials and methods In this IRB-approved retrospective study, 69 biopsy-proven renal tumors in 56 patients, who underwent MWA in our institution from January 2013 to March 2017, were evaluated. Data collection included demographics, tumor characteristics, procedural protocols, and follow-up visits within 6 months post procedure. Primary outcomes were assessed by technical success (TS), local tumor progression (LTP), and complications. The Kaplan–Meier analysis was used for survival rate. Results Overall technical success was achieved for all 69 lesions (92.8% primary TS, 100% overall). Median nephrometry score was 8 (4–11) and median tumor size was 2.5 cm (0.8–7). Five lesions which required second ablation had significantly higher median tumor size 4 cm ( P  = 0.039) with the same nephrometry score. Renal function remained stable with no significant change in eGFR before or after ablation. The LTP rate was 5.8%. The most recurrent tumors were clear cell (50%) followed by papillary tumors (25%). The complication rate was 5.8% with minor complications (hematoma and pain) and no major issues. There was no significant association between nephrometry score and technical success, recurrence, or complication rates. Overall and tumor-specific survival rates were 96.7% and 100% at 11.9 months. Conclusions Image-guided MWA appears to be a safe and effective treatment regardless of nephrometry score and tumor location with high technical success, low recurrence, and complication rates.