CT-guided Microwave Ablation is a Promising Ablative Modality for Patients with Localized RCC

Computed tomography (CT)-guided percutaneous microwave ablation is safe and well-tolerated in patients with renal cell carcinoma (RCC) and achieves nephron preservation similar to existing ablative modalities, according to a study published in the Journal of Vascular and Interventional Radiology.

This retrospective review included 38 patients who underwent CT-guided microwave ablation for stage T1N0M0 RCC between October 2015 and December 2017. Baseline characteristics, including coexistent morbidities, were gathered from medical records. Blood urea nitrogen (BUN), creatinine, or glomerular filtration rate (eGFR) measurements at 1 month or 1 year after ablation were required for inclusion in this analysis,

Renal function stability was assessed by comparing BUN, creatinine levels, and eGFR before and after ablation. Complication rates, technical success, and treatment response were also assessed.

A total of 44 T1N0M0 RCCs with a median tumor size of 2.5 cm were treated with CT-guided MW ablation. One month after treatment renal function was measured.

At baseline mean eGFRs were 60 mL/min/1.73 m2 and a 1 month after ablation 59 mL/min/1.73 m2. At The means of difference were 3.3% (95% confidence interval, -4.4 to 4.3; P = 0.99) at 1 year follow up and 3.3% (95% confidence interval, -4.3 to 4.8; P = 0.91) at last follow up.

The 2-years freedom from eGFR decrease to < 60 mL/min/1.73 m2 was 2% (P = 0.91). There was no significant postablative onset of decline or chronic kidney disease upstaging for the patients (n = 5, 13%) with preexisting stage 4 chronic kidney disease.

The authors concluded that “CT-guided MW ablation is a promising ablative modality that offers favorable safety and renal function outcomes for patients with localized stage T1 RCC. Prospective long-term studies should be prioritized to further establish the clinical outcomes of [microwave] ablation in in the context of existing ablative therapies and surgical approaches.”

 

--Kelsey Moroz

 

Reference:

Zhou W, Herwald SE, Uppot RN, Arellano RS. Risk Assessment of Chronic Kidney Disease Following Microwave Ablation for Stage T1 Renal Cell Carcinoma. J Vasc Interv Radiol. 2018; pii: S1051-0443(18)31295-8. doi: 10.1016/j.jvir.2018.06.021. [Epub ahead of print]