Limited ability of the renal ablation-specific (MC)2 risk scoring system to predict major adverse events from percutaneous renal microwave ablation

• Published in: Clinical imaging 2023-08, Vol.100, p.30-35
• Main Authors: Savage, Cody H., Devane, A. Michael, Li, Yufeng, Li, Mei, Schammel, Noah C., Little, Madison E., Schammel, Christine, Pigg, Richard A., El Khudari, Husammedin, Rais-Bahrami, Soroush, Huang, Junjian, Gunn, Andrew J.
• Format: Article
• Language: English
• Subjects: (MC)2 score; Microwave ablation; Renal cell carcinoma; Risk stratification
• ISSN: 0899-7071; 1873-4499
• DOI: 10.1016/j.clinimag.2023.05.001

To access if the (MC)2 scoring system can identify patients at risk for major adverse events following percutaneous microwave ablation of renal tumors. Retrospective review of all adult patients who underwent percutaneous renal microwave ablation at two centers. Patient demographics, medical histories, laboratory work, technical details of the procedure, tumor characteristics, and clinical outcomes were collected. The (MC)2 score was calculated for each patient. Patients were assigned to low-risk (8) groups. Adverse events were graded according to the criteria from the Society of Interventional Radiology guidelines. A total of 116 patients (mean age = 67.8 [95%CI 65.5–69.9], 66 men) were included. 10 (8.6%) and 22 (19.0%) experienced major or minor adverse events, respectively. The mean (MC)2 score for patients with major adverse events (4.6 [95%CI 3.3–5.8]) was not higher than those with either minor adverse events (4.1 [95%CI 3.4–4.8], p = 0.49) or no adverse events (3.7 [95%CI 3.4–4.1], p = 0.25). However, mean tumor size was greater in those with major adverse events (3.1 cm [95%CI 2.0–4.1]) than minor adverse events (2.0 cm [95%CI 1.8–2.3], p = 0.01). Patients with central tumors were also more likely to experience major adverse events compared to those without central tumors (p = 0.02). The area under the receiver operator curve to predict major adverse events was 0.61 (p = 0.15), indicating a poor ability of the (MC)2 score to predict major adverse events. The (MC)2 risk scoring system does not accurately identify patients at risk for major adverse events from percutaneous microwave ablation of renal tumors. The mean tumor size and central tumor location may serve as a better indicator for risk assessment of major adverse events. •(MC)2 score was not higher in patients with major adverse events, compared to minor or no events.•Tumor size was greater in patients with major adverse events than patients with minor adverse events.•Patients with central tumors were also more likely to experience major adverse events compared to those without central tumors.•(MC)2 score has poor ability to predict major adverse events.•Tumor size and tumor centrality may serve as better predictive factors of major adverse events.