Image-guided microwave ablation (MWA) is effective for treating renal cell carcinoma, according to findings published August 17 in the Journal of Vascular and Interventional Radiology.
MWA guided by either CT or contrast-enhanced ultrasound (CEUS) is tied to “excellent” long-term overall, cancer-specific, and local tumor progression-free survival when treating T1 cancers, wrote a team led by Daniel Kim, MD from the University of California, Los Angeles.
These results came “with minimal short and long-term complications with no effect on renal function,” Kim and fellow researchers highlighted.
While surgery is the traditional treatment option for renal cell carcinoma, researchers continue to explore how both active surveillance and percutaneous thermal ablation can treat patients with comorbidities. Proponents for ablation reason that most T1 lesions “grow very slowly.”
Furthermore, recent studies favor ablation’s safety profile, with few treatment-related complications reported. And most complications from these studies have been minor.
Kim and colleagues studied the technical success of MWA and outcomes for patients who underwent this treatment for renal cell carcinoma. The study included 86 biopsy-proven renal cell carcinoma cases from 81 patients with an average age of 67.6 years. The patients underwent MWA under either percutaneous CT or CEUS and had a median follow-up of 76.8 months. The team also analyzed MWA’s effects on T1a (4cm or less) and T1b (4 cm to 7 cm) cancers.
The team reported the following findings:
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MWA achieved high overall (100%), primary (98%), and secondary (100%) technical success.
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MWA achieved 10-year overall, cancer-specific, and local tumor progression-free survival rates of 76%, 85%, and 83%, respectively.
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The T1b subcohort achieved a lower eight-year local tumor progression-free survival rate compared to the T1a subcohort (p = 0.003).
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MWA did not affect renal function, with the pre-ablation and two-to-three-year post-ablation estimated glomerular filtration rates (58.5 vs. 58.4 mL/min/1.73m2) being stable (p = 0.93).
Finally, the researchers found a 2% overall incidence of complications, all Clavien-Dindo grade I events. They highlighted that this low incidence rate “may reflect the use of multimodality imaging assessment, including CEUS, patient and lesion selection, hydrodissection techniques, and operator experience.”
The authors suggested that comparative studies could find out whether multiple intraprocedural imaging checkpoints could improve local control or technical success compared with simpler workflows.
Read the full study here.