Percutaneous microwave ablation of renal cancers under CT guidance: safety and efficacy with a 2-year follow-up

• Published in: Clinical radiology Vol. 72; no. 9; pp. 786 - 792
• Main Authors: Chan, P., Vélasco, S., Vesselle, G., Boucebci, S., Herpe, G., Debaene, B., Ingrand, P., Irani, J., Tasu, J.-P.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-09-2017
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma, Renal Cell - diagnostic imaging; Carcinoma, Renal Cell - surgery; Catheter Ablation - methods; Contrast Media; Female; Follow-Up Studies; Humans; Kidney Neoplasms - diagnostic imaging; Kidney Neoplasms - surgery; Male; Microwaves - therapeutic use; Middle Aged; Patient Safety; Radiography, Interventional; Retrospective Studies; Survival Rate; Tomography, X-Ray Computed
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2017.03.029

To evaluate the safety and efficiency of percutaneous microwave ablation (MWA) of renal cell carcinomas (RCC) carried out under computed tomography (CT) guidance.
A retrospective study was performed on RCC that was either histologically proven or diagnosed at imaging (Bosniak IV cyst) and treated by MWA under general anaesthesia with CT guidance. Indications for percutaneous ablation were based on the American Urological Association recommendations. Twenty-four months post-procedure follow-up was performed.
Sixty-two patients presenting one or more RCC (84 tumours ranging from 10–48 mm in diameter; mean diameter: 25.6 mm) were included. Technical success was achieved for 78 tumours (58 patients). For four patients, the treatment was stopped due to gas dissection failure. At 3 months, six residual tumours were observed (8%). At 6 months, two recurrences and one residual tumour (3.8%) were observed; all were retreated with complete success. At 12 months, local control of the disease was achieved in 94% of cases (100% in cases where treatment was performed). Two cases of distal metastasis were observed after 12 and 24 months. At 24 months, one patient presented with a contralateral tumour. The complication rate was 4.8% including one grade III complication and two grade II complications according to the Clavien–Dindo classification. At 2 years, the cumulative disease-free survival rate and overall survival were 95% and 97%, respectively.
MWA ablation under CT guidance to treat RCC is safe and provides a high rate of effectiveness at 24 months.
•The computed tomography (CT)-guided approach for microwave ablation (MWA) of renal cell carcinoma (RCC) allows treatment with safe results of almost all targets, even in cases of organs at risk.•MWA of RCC is associated with less than a 5% complication rate.•At 2 years, the cumulative disease-free survival rate and the overall survival rate were respectively 95% and 97%.