Clinical safety and efficacy of microwave ablation for small renal masses

Abstract

Purpose: CT-guided MWA is a safe and eff ective tool that should be utilized in the treatment of small renal masses (SRMs). We aim to clarify the utility of CT-guided MWA by examining patient outcomes such as recurrence, treatment success, changes in renal function, and complications.Methods: A retrospective review of consecutive patients with SRMs who underwent same day renal mass biopsy (RMB) and CT-guided MWA between 2015 and 2022 was performed.Treatment safety was assessed by 30-day complications according to the Clavien-Dindo system and change in eGFR >30 days post-procedure. Treatment eff icacy was defined by local recurrence and incomplete treatment rates and calculated using the Kaplan-Meier method.Results: A total of 108 renal masses were found in 104 patients. The overall complication rate was 7.4% (8/108), of which 4 were major complications (3.7%). For those with renal function available >30 days post ablation, the median eGFR was 47.2 (IQR: 36.0, 57), compared to 52.3 (IQR: 43.7, 61.5) pre-ablation, p<0.0001. 5-year local recurrence free survival was 86%.Among those with biopsy proven malignancy (n= 66), there were five local recurrences (7.54%) occurring at a median of 25.1 months (IQR 19.9, 36.2) and one case (1.5%) of incomplete treatment. Conclusions:As the medical field continues to evolve towards less invasive interventions, MWA off ers a valuable tool in the management of renal masses. With low major complication and recurrence rates, our findings support the utility of CT-guided MWA as a tool for treatment of SRMs.

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“…The group of Dr. Westerman performed in page 227 ( 9 ) a nice study about the clinical safety and efficacy of microwave ablation (MWA) for small renal masses (SRMs) and concluded that these findings support the utility of CT-guided MWA as a tool for treatment of SRMs.…”