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Tumor location does not impact oncologic outcomes for percutaneous microwave ablation of clinical T1a renal cell carcinoma

  • Vascular-Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To evaluate the impact of anterior tumor location on oncologic efficacy, complication rates, and procedure duration for 151 consecutive biopsy-proven clinical T1a renal cell carcinoma (RCC) treated with percutaneous microwave (MW) ablation.

Methods

This single-center retrospective study was performed under a waiver of informed consent. One hundred forty-eight consecutive patients (103 M/45 F; median age 67 years, IQR 61–73) with 151 cT1a biopsy-proven RCC (median diameter 2.4 cm, IQR 1.9–3.0) were treated with percutaneous MW ablation between March 2011 and August 2017. Patient and procedural data collected included Charlson comorbidity index (CCI), RENAL nephrometry score (NS), use of hydrodisplacement, MW antennas/generator output/time, and procedure time (PT). Data were stratified by anterior, posterior, and midline tumor location and compared with the Kruskal–Wallis or chi-squared tests. The Kaplan–Meier method was used for survival analyses.

Results

Tumor size, NS, and use/volume of hydrodisplacement were similar for posterior and anterior tumors (p > 0.05). Patients with anterior tumors had a higher CCI (3 vs 4, p = 0.001). Median PT for posterior and anterior tumors was similar (100 vs 108 min, p = 0.26). Single session technical success and primary efficacy were achieved for all 151 tumors including 61 posterior and 67 anterior tumors. The 4 (3%) Clavien III–IV complications and 6 (4%) local recurrences were not associated with tumor location (p > 0.05). Three-year RFS, CSS, and OS were 95% (95% CI 0.87, 0.98), 100% (95% CI 1.0, 1.0), and 96% (95% CI 0.89, 0.98), respectively.

Conclusions

The safety and efficacy of percutaneous microwave ablation for anterior and posterior RCC are similar.

Key Points

• The safety profile for percutaneous microwave ablation of anterior and posterior T1a renal cell carcinoma is equivalent.

• Percutaneous microwave ablation of T1a renal cell carcinoma provides durable oncologic control regardless of tumor location.

• Placement of additional microwave antennas and use of hydrodisplacement are associated with longer procedure times.

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Abbreviations

a:

Anterior

BMI:

Body mass index

CCI:

Charlson comorbidity index

CECT:

Contrast-enhanced CT

CS:

Conscious sedation

CSS:

Cancer-specific survival

CT:

Computed tomography

ECOG:

European Cooperative Oncology Group

GA:

General anesthesia

IQR:

Interquartile range

LTP:

Local tumor progression

MRI:

Magnetic resonance imaging

MW:

Microwave

NS:

RENAL nephrometry score

OS:

Overall survival

p:

Posterior

RCC:

Renal cell carcinoma

RFS:

Recurrence-free survival

US:

Ultrasound

W:

Watts

X:

Midline

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. University of Wisconsin School of Medicine and Public Health, Health Sciences Learning Center, 750 Highland Avenue, Madison, WI, 53705, USA

    Kim A. Maciolek

  2. Department of Urology, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Madison, WI, 53705, USA

    E. Jason Abel, Natasza M. Posielski, J. Louis Hinshaw & Fred T. Lee Jr

  3. Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, E3/376 Clinical Science Center, Madison, WI, 53792, USA

    J. Louis Hinshaw, Meghan G. Lubner, Fred T. Lee Jr, Timothy J. Ziemlewicz & Shane A. Wells

Authors
  1. Kim A. Maciolek
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  2. E. Jason Abel
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  3. Natasza M. Posielski
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  4. J. Louis Hinshaw
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  5. Meghan G. Lubner
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  6. Fred T. Lee Jr
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  7. Timothy J. Ziemlewicz
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  8. Shane A. Wells
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Corresponding author

Correspondence to Shane A. Wells.

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Guarantor

The scientific guarantor of this publication is Shane A. Wells.

Conflict of interest

The authors (JLH, FTL, TJZ, SAW) of this manuscript declare relationships with the following companies: Ethicon, Inc. (paid consultant).

Statistics and biometry

One of the authors (KAM) has significant statistical expertise.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported in Klapperich ME, Abel EJ, Ziemlewicz TJ, Best SL, Lubner MG, Nakada SY, Hinshaw JL, Brace CL, Lee FT Jr., Wells SA. Effect of tumor complexity and technique on efficacy and complications after percutaneous microwave ablation of stage T1a renal cell carcinoma: A single-center, retrospective study. Radiology 2017;284(1):272–280. PMID: 28076721.

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Maciolek, K.A., Abel, E.J., Posielski, N.M. et al. Tumor location does not impact oncologic outcomes for percutaneous microwave ablation of clinical T1a renal cell carcinoma. Eur Radiol 29, 6319–6329 (2019). https://doi.org/10.1007/s00330-019-06121-y

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  • DOI: https://doi.org/10.1007/s00330-019-06121-y

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