Percutaneous Microwave Ablation Versus Robot-Assisted Partial Nephrectomy for Stage I Renal Cell Carcinoma: A Propensity-Matched Cohort Study Focusing Upon Long-Term Follow-Up of Oncologic Outcomes

• Published in: Cardiovascular and interventional radiology Vol. 47; no. 5; pp. 573 - 582
• Main Authors: Chlorogiannis, David-Dimitris, Kratiras, Zisis, Efthymiou, Evgenia, Moulavasilis, Napoleon, Kelekis, Nikolaos, Chrisofos, Michail, Stravodimos, Konstandinos, Filippiadis, Dimitris K.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-05-2024; Springer Nature B.V
• Subjects: Ablation; Aged; Carcinoma, Renal Cell - diagnostic imaging; Carcinoma, Renal Cell - pathology; Carcinoma, Renal Cell - surgery; Cardiology; Clinical Investigation; Computed tomography; Female; Follow-Up Studies; Humans; Imaging; Interventional Oncology; Kidney cancer; Kidney Neoplasms - diagnostic imaging; Kidney Neoplasms - pathology; Kidney Neoplasms - surgery; Male; Matching; Medicine; Medicine & Public Health; Metastases; Metastasis; Microwave ablation; Microwaves - therapeutic use; Middle Aged; Neoplasm Staging; Nephrectomy; Nephrectomy - methods; Nuclear Medicine; Propensity Score; Radiography, Interventional - methods; Radiology; Rank tests; Regression analysis; Renal cell carcinoma; Retrospective Studies; Robotic surgery; Robotic Surgical Procedures - methods; Statistical analysis; Survival; Survival Rate; Tomography, X-Ray Computed; Treatment Outcome; Ultrasound; Robot-assisted partial nephrectomy; Microwave ablation; Renal cancer; Renal cell carcinoma; Kidney cancer; Thermal ablation; Overall survival
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-024-03695-z

Purpose
To retrospectively compare long-term oncologic outcomes of percutaneous computed tomography-guided microwave ablation (MWA) and robot-assisted partial nephrectomy (RAPN) for the treatment of stage 1 (T1a and T1b) renal cell carcinoma (RCC) patients.
Materials and Methods
Institutional database research identified all T1 RCC patients who underwent either MWA or RAPN. Models were adjusted with propensity score matching. Kaplan–Meier log-rank test analyses and Cox proportional hazard regression models were used to compare the oncologic outcomes. Patient and tumor characteristics, technical success as well as oncologic outcomes were evaluated and compared between the 2 groups.
Results
After propensity score matching, a total of 71 patients underwent percutaneous MWA (mean age 70 ± 10 years) and 71 underwent RAPN (mean age 60 ± 9 years). At 8-year follow-up, the estimated survival rates for MWA cohort were 98% (95% confidence interval [CI] 95–100%) for overall survival, 97% (95% CI 93–100%) for recurrence-free survival, and 97% (95% CI 93–100%) for metastasis-free survival. The matched cohort that underwent RAPN exhibited survival rates of 100% (95% CI 100–100%) for overall survival, 98% (95% CI 94–100%) for recurrence-free survival, and 98% (95% CI 94–100%) for metastasis-free survival. After performing log-rank testing, these rates were not significantly different (
p
values of 0.44, 0.67, and 0.67, respectively).
Conclusion
The results of the present study suggest that both MWA and RAPN are equally effective in terms of oncologic outcome for the treatment of T1 RCC.