Introduction of Microwave Ablation Into a Renal Ablation Practice: Valuable Lessons Learned

Thompson, Scott M.; Schmitz, John J.; Thompson, R. Houston; Weisbrod, Adam J.; Welch, Brian T.; Viers, Boyd R.; Hannon, James D.; Schmit, Grant D.; Atwell, Thomas D.; Kurup, A. Nick

doi:10.2214/ajr.18.19775

Cited by 30 publications

(26 citation statements)

References 38 publications

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“…The LTR in this study was 4% over a 108 histologically proven RCCs. In the literature, LTR ranges from 0 to 17% [7,12,29], but most papers included every renal lesions without excluding non-diagnostic or benign lesions whereby efficacy and recurrence rates might be overestimated [23,31,33]. Surprisingly, the time to LTR was long in this current cohort which could be explained by the difficulties in detecting of recurrences in hypo-vascular tumours and slow growth rates of low-grade tumours.…”

Section: Discussionmentioning

confidence: 80%

Percutaneous Microwave Ablation of Histologically Proven T1 Renal Cell Carcinoma

Aarts

Prevoo

Meier

et al. 2020

Cardiovasc Intervent Radiol

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Objectives To assess the safety and efficacy of percutaneous microwave ablation (MWA) of histologically proven T1 renal cell carcinoma (RCC). Methods We analysed patients with a histologically proven RCC (B 7 cm) treated by MWA from April 2012-April 2018. Primary and secondary efficacy, local tumour recurrence (LTR), morbidity and mortality were reported. Efficacy was defined as no residual tumour enhancement on follow-up imaging 1 month after the first ablation (primary efficacy) and after re-ablation(s) for residual disease (secondary efficacy). Adverse events (AE) were registered by the Clavien-Dindo classification and the common terminology criteria for AE. Univariable and multivariable logistic regression analyses were performed to investigate a relation among pre-treatment factors incomplete ablation and complications. Results In 100 patients, a total of 108 RCCs (85 T1a and 23 T1b) were treated by MWA. Median size was 3.2 cm (IQR 2.4-4.0). Primary efficacy was 89% (95%CI 0.81-0.94) for T1a lesions and 52% (95%CI 0.31-0.73) for T1b lesions (p \ 0.001). Fifteen lesions (7 T1a) were reablated for residual disease by MWA in one (n = 13) and two (n = 2, both T1b) sessions resulting in secondary efficacy rates of 99% (T1a) and 95% (T1b, p = 0.352). LTR occurred in four tumours (2 T1a, 2 T1b) after 10-60 months. Six (4%) AEs grade [ 3-5 were observed (2 T1a, 4 T1b, p = 0.045). Multivariable analysis showed that mR.E.N.A.L. nephrometry was independently associated with incomplete ablation (p = 0.012). Conclusion Microwave ablation is safe and effective for T1a and T1b RCC lesions with a significantly lower primary efficacy for T1b lesions.

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Section: Discussionmentioning

confidence: 80%

Percutaneous Microwave Ablation of Histologically Proven T1 Renal Cell Carcinoma

Aarts

Prevoo

Meier

et al. 2020

Cardiovasc Intervent Radiol

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“…Nine studies, including 552 lesions treated with MWA, were included (►Table 2). [54][55][56][57][58][59][60][61][62] All but one study pertained to percutaneous approach alone. Average lesion size was 2.8 cm.…”

Section: Review Of Contemporary Oncologic Outcomesmentioning

confidence: 99%

Systematic Review of Contemporary Evidence for the Management of T1 Renal Cell Carcinoma: What IRs Need to Know for Kidney Cancer Tumor Boards

Cronan

Dariushnia

Bercu

et al. 2019

Semin intervent Radiol

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Renal cell carcinoma is a relatively common malignancy, with 60 to 70 thousand cases a year in the United States alone. Increased utilization of cross-sectional imaging has led to an increase in the number of early renal cell cancers seen by the medical establishment. In addition, certain patient populations have an increased risk of developing kidney cancers which may mandate aggressive screening protocols. This article discusses the epidemiology of renal cell cancers; discusses the current management guidelines from multiple specialty societies; discusses some of the surgical and interventional techniques used in the treatment of such lesions; and provides a review of the literature regarding treatments of early-stage renal cell cancers.

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“…In a retrospective review of 2,040 procedures (448 cryoablation and 1,592 PN) for solitary renal masses, Mason et al found a decrease of 3.1 mL/min/1.73 m 2 in the cryoablation cohort as compared with 1.1 mL/min/ 1.73 m 2 in the PN cohort (p ¼ 0.038). 26 At 3-month follow-up, the difference was still significant (cryoablation: 4.3 vs. PN: 2.1 mL/min/1.73 m 2 , p ¼ 0.008).…”

Section: Reduction In Glomerular Filtration Ratementioning

confidence: 89%

“…Therefore, because PN is in general more invasive, Clavien-Dindo tends to underrepresent the difference in morbidity between the two procedures. 26 They reported a major complication rate of 11.5% (3/27) which included two ureteropelvic junction (UPJ) strictures and one hemorrhage which resulted in death. Other complications such as abscess, damage to surrounding structures (bowel, abdominal wall, etc.…”

Section: Complication Grading Systems and Common Complicationsmentioning

confidence: 99%

Thermal Ablation of T1a Renal Cell Carcinoma: The Clinical Evidence

Young

Golzarian

Anderson

2019

Semin intervent Radiol

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Renal cell carcinoma (RCC) is most commonly diagnosed at an early (T1a) stage and is typically amenable to several effective treatments. The current gold standard therapy is partial nephrectomy, given its decreased morbidity and similar oncologic outcomes when compared with radical nephrectomy. Thermal ablation is an evolving definitive therapy for T1a RCC which is even less invasive than partial nephrectomy. This article reviews the evidence for thermal ablation in the treatment of T1a RCC and compares outcomes of existing ablation modalities with surgical management.

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Introduction of Microwave Ablation Into a Renal Ablation Practice: Valuable Lessons Learned

Cited by 30 publications

References 38 publications

Percutaneous Microwave Ablation of Histologically Proven T1 Renal Cell Carcinoma

Percutaneous Microwave Ablation of Histologically Proven T1 Renal Cell Carcinoma

Systematic Review of Contemporary Evidence for the Management of T1 Renal Cell Carcinoma: What IRs Need to Know for Kidney Cancer Tumor Boards

Thermal Ablation of T1a Renal Cell Carcinoma: The Clinical Evidence

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