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Percutaneous microwave ablation of T1a and T1b renal cell carcinoma: short-term efficacy and complications with emphasis on tumor complexity and single session treatment

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Abstract

Purpose

To update the oncologic outcomes and safety for microwave (MW) ablation of T1a (≤4.0 cm) and T1b (4.1–7.0 cm) renal cell carcinoma (RCC) with emphasis on tumor complexity and single session treatment.

Materials and Methods

Retrospective review of 29 consecutive patients (30 tumors) with localized (NOMO) RCC (23 T1a; 7 T1b) treated with percutaneous MW ablation between 3/2013 and 6/2014. Primary outcomes investigated were technical success, local tumor progression (LTP), and complications. Technical success was assessed with contrast-enhanced computed tomography (CECT) immediately after MW ablation. Presence of LTP was assessed with CECT or contrast-enhanced magnetic resonance at 6-month target intervals for the first two years and annually thereafter. Complications were categorized using the Clavien-Dindo classification system.

Results

Median tumor diameter was 2.8 cm [IQR 2.1–3.3] for T1a and 4.7 cm [IQR 4.1–5.7] for T1b tumors. Median RENAL nephrometry score was 7 [IQR 4–8] for T1a tumors and 9 [IQR 6.25–9.75] for T1b tumors. Technical success was achieved for 22 T1a (96%) and 7 T1b (100%) tumors. There were no LTP during a median imaging follow-up of 12.0 months [IQR 6–18] for the 23 patients (24 tumors) with greater than 6 months of follow-up. There were three Clavien-Dindo grade I–II complication (10%) and no Clavien-Dindo grade III–V complications (0%). All but two patients (93%) are alive without metastatic disease; two patients died after 12-month follow-up of causes unrelated to the MW ablation.

Conclusion

Percutaneous MW ablation appears to be a safe and effective treatment option for low, moderate, and highly complex T1a and T1b RCC in early follow-up.

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Author information

Authors and Affiliations

  1. Department of Radiology, University of Wisconsin, 600 Highland Avenue, E3/376, Madison, WI, 53792, USA

    Shane A. Wells

  2. Department of Urology, University of Virginia, 1215 Lee Street, Charlottesville, VA, 22903, USA

    Karen M. Wheeler, Mehul S. Patel & Noah S. Schenkman

  3. Department of Radiology, University of Virginia, 1215 Lee Street, Charlottesville, VA, 22903, USA

    Ayman Mithqal

  4. Department of Biomedical Engineering, Wisconsin Institutes of Medical Research, 111 Highland Avenue, Madison, WI, 53705, USA

    Christopher L. Brace

Authors
  1. Shane A. Wells
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  2. Karen M. Wheeler
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  3. Ayman Mithqal
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  4. Mehul S. Patel
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  5. Christopher L. Brace
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  6. Noah S. Schenkman
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Corresponding author

Correspondence to Shane A. Wells.

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Funding

Neither internal nor external funding was provided for this research.

Conflict of interest

CL Brace is a shareholder and consultant for NeuWave Medical Inc. and Symple Surgical and receives grant support from the National Institute of Health. SA Wells, KM Wheeler, A Mithqal, MS Patel, and NS Schenkman have no potential conflict of interest.

Ethical approval

This study represents a retrospective review of patients who received tumor ablation as a part of clinical care. Tumor ablation is considered an alternative to surgery and is standard of care. Research was not performed on animals in this study.

Informed consent

The study is compliant with the Health Insurance Portability and Accountability Act. The requirement for informed consent was waived.

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Wells, S.A., Wheeler, K.M., Mithqal, A. et al. Percutaneous microwave ablation of T1a and T1b renal cell carcinoma: short-term efficacy and complications with emphasis on tumor complexity and single session treatment. Abdom Radiol 41, 1203–1211 (2016). https://doi.org/10.1007/s00261-016-0776-x

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  • DOI: https://doi.org/10.1007/s00261-016-0776-x

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