Clinical safety and efficacy of microwave ablation for small renal masses

ABSTRACT Purpose: CT-guided MWA is a safe and effective 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. Method...

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Published in:	International Brazilian Journal of Urology Vol. 50; no. 3; pp. 277 - 286
Main Authors:	Foret, Ashley, Haaga Jr, Christopher B., Jain, Shivani, Baumgartner, Chelsea O., Escott, Megan, Henderson, Benjamin R., O'Brien, Sean T., Delacroix Jr, Scott E., Gills, Jessie R.R., Westerman, Mary E.
Format:	Journal Article
Language:	English
Published:	Sociedade Brasileira de Urologia 01-05-2024
Subjects:	Kidney Neoplasms Original Radiofrequency Ablation Transurethral Resection of Prostate
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Summary:	ABSTRACT Purpose: CT-guided MWA is a safe and effective 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 efficacy 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 offers 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.
Bibliography:	CONFLICT OF INTEREST None declared.
ISSN:	1677-5538 1677-6119
DOI:	10.1590/s1677-5538.ibju.2024.0017