Microwave versus cryoablation and radiofrequency ablation for small renal mass: a multicenter comparative analysis

Pandolfo, Savio Domenico; Carbonara, Umberto; Beksaç, Alp Tuna; Derweesh, Ithaar; Celia, Antonio; Schiavina, Riccardo; Elbich, Jeffrey; Basile, Giuseppe; Hampton, Lance J.; Cerrato, Clara; Costa, Giovanni; Bianchi, Lorenzo; Lucarelli, Giuseppe; Mirone, Vincenzo; Imbimbo, Ciro; KIM, Fernando J.; Giudice, Francesco Del; Capitanio, Umberto; Kaouk, Jihad; Autorino, Riccardo

doi:10.23736/s2724-6051.22.05092-3

Cited by 28 publications

(22 citation statements)

References 34 publications

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“…In recent years, thermal ablation has been gaining popularity, and is now accepted as one of the treatment methods in SRMs, including successful treatment of obese patients and cystic lesions [3,[20][21][22][23]. Some authors reported comparable results of thermal ablation and NSS in selected patients [9,20,24].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Percutaneous Thermal Ablation of Renal Cancers—In Search for the Ideal Tumour

Jasiński

Bielinska

Siekiera

et al. 2023

Cancers

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Over the recent years, the progress in imaging techniques has led to an increased detection of kidney tumours, including small renal masses. While surgery is still the standard of care, there is a growing interest in minimally invasive methods. Ultrasound (US)-guided percutaneous ablation is particularly attractive because it is a safe and relatively simple procedure. In this study, we investigated the success of percutaneous radiofrequency ablation (RFA) in relation to kidney tumour diameter and location. Between August 2016 and September 2021, 253 patients with 259 renal tumours underwent US-guided RFA as a primary treatment in our institution. A total of 67 patients were excluded from this study. Abdominal computed tomography (CT) and tumour biopsy were performed before the procedure. Patients were followed with contrast-enhanced CT, the average follow-up time was 28 months. The studied group was composed of 186 patients with 191 renal tumours—only biopsy-confirmed renal cancers were included. During the follow-up, 46 cases of residual disease and 4 cases of local progression were found. There was a significant correlation between tumour size and the ablation success rate. The success rate was 73.5% and 87.6% for lesions ≤25 mm, 94.6% for lesions ≤25 mm and exophytic, 79.1% for lesions 26–30 mm and 84.4% for lesions 26–30 mm and exophytic, respectively. Four Clavien-Dindo grade ≥2 complications were observed. US-guided percutaneous RFA of T1a renal cancers is safe and well-tolerated. Its effectiveness depends on tumour size, with best results for exophytic lesions smaller than 3 cm. Most of the recurrent or residual tumours can be successfully re-treated with US-guided percutaneous RFA.

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Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Percutaneous Thermal Ablation of Renal Cancers—In Search for the Ideal Tumour

Jasiński

Bielinska

Siekiera

et al. 2023

Cancers

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“…Renal cell carcinoma (RCC) is the sixth most common cancer in males and the ninth most common cancer in females, accounting for 78,000 newly diagnosed cases in 2018 in the United States, representing the third leading cause of mortality amongst genitourinary malignancies [1]. Nowadays, radical nephrectomy is the gold standard for large and locally advanced RCC [2], while nephron sparing surgery is the preferred for smaller localized tumors with percutaneous tumor ablation recognized as a safe option [3][4][5][6]; metastatic RCC (mRCC) management is more demanding, with conflicting results reported. Indeed, 5-year survival rates for mRCC range from 0 to 20% [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Cytoreductive Nephrectomy and Metastatic Renal Cell Carcinoma: State of the Art and Future Perspectives

et al. 2023

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In the past decades, several treatments have been proposed for the management of metastatic renal cell carcinoma (mRCC). Among these, cytoreductive nephrectomy (CN) represents a controversial and open issue in the era of targeted therapy and novel immunotherapy with immune checkpoint inhibitors. Two important studies, CARMENA and SURTIME, analyzed therapy with sunitinib with or without CN, and immediate CN followed by sunitinib versus a deferred CN after three cycles of sunitinib, respectively. CARMENA showed the non-inferiority of sunitinib alone versus sunitinib plus CN, whereas SURTIME showed no difference in progression-free survival (PFS), but a better median OS among patients with deferred CN. Therefore, more prospective clinical trials and appropriate patient identification are necessary to support CN in this new scenario. This review provides a snapshot of the current evidence for CN in mRCC, discusses the management strategies, and offers perspectives on the direction of future research.

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“…Tumor ablation technologies, which include radiofrequency ablation (RFA), microwave ablation (MWA), high intensity focused ultrasound (HIFU), and cryoablation (CA), utilize diverse forms of energy and physical mechanisms to directly kill tumor tissues. Several reviews comparing different tumor ablation strategies have been published recently [ 8 , 9 , 10 , 11 , 12 ]. CA is an established method for treating certain prostate cancers [ 13 , 14 , 15 ] and small renal masses [ 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Focal Cryo-Immunotherapy with Intratumoral IL-12 Prevents Recurrence of Large Murine Tumors

Vrabel

Schulman

Gillam

et al. 2023

Cancers

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Focal ablation technologies are routinely used in the clinical management of inoperable solid tumors but they often result in incomplete ablations leading to high recurrence rates. Adjuvant therapies, capable of safely eliminating residual tumor cells, are therefore of great clinical interest. Interleukin-12 (IL-12) is a potent antitumor cytokine that can be localized intratumorally through coformulation with viscous biopolymers, including chitosan (CS) solutions. The objective of this research was to determine if localized immunotherapy with a CS/IL-12 formulation could prevent tumor recurrence after cryoablation (CA). Tumor recurrence and overall survival rates were assessed. Systemic immunity was evaluated in spontaneously metastatic and bilateral tumor models. Temporal bulk RNA sequencing was performed on tumor and draining lymph node (dLN) samples. In multiple murine tumor models, the addition of CS/IL-12 to CA reduced recurrence rates by 30–55%. Altogether, this cryo-immunotherapy induced complete durable regression of large tumors in 80–100% of treated animals. Additionally, CS/IL-12 prevented lung metastases when delivered as a neoadjuvant to CA. However, CA plus CS/IL-12 had minimal antitumor activity against established, untreated abscopal tumors. Adjuvant anti-PD-1 therapy delayed the growth of abscopal tumors. Transcriptome analyses revealed early immunological changes in the dLN, followed by a significant increase in gene expression associated with immune suppression and regulation. Cryo-immunotherapy with localized CS/IL-12 reduces recurrences and enhances the elimination of large primary tumors. This focal combination therapy also induces significant but limited systemic antitumor immunity.

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Microwave versus cryoablation and radiofrequency ablation for small renal mass: a multicenter comparative analysis

Cited by 28 publications

References 34 publications

Ultrasound-Guided Percutaneous Thermal Ablation of Renal Cancers—In Search for the Ideal Tumour

Ultrasound-Guided Percutaneous Thermal Ablation of Renal Cancers—In Search for the Ideal Tumour

Cytoreductive Nephrectomy and Metastatic Renal Cell Carcinoma: State of the Art and Future Perspectives

Focal Cryo-Immunotherapy with Intratumoral IL-12 Prevents Recurrence of Large Murine Tumors

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