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Midterm results of percutaneous microwave ablation under ultrasound guidance versus retroperitoneal laparoscopic radial nephrectomy for small renal cell carcinoma

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Abstract

Laparoscopic radial nephrectomy (LRN) and microwave ablation (MWA) are optional treatment for renal cell carcinoma (RCC). However, the comparative study with two techniques remains lacking. The aim of this study was to evaluate midterm results of MWA vs. LRN in patients with small RCC. A total of 426 patients with ≤4 cm RCC were included from April 2006 to October 2012. Ninety-eight patients underwent MWA and 328 patients LRN. The survival, recurrence, and renal function changes were compared between two treatments. Although overall survival after MWA (82.6% at 5 years) was lower than those after LRN (98.6% at 5 years, p = 0.0004), the RCC-related survival (97% at 5 years) was comparable to those following LRN (98% at 5 years, p = 0.38). One local tumor progress occurred at 32 months after MWA and none after LRN. The major complication rates were comparable between two techniques (1.7% in MWA vs. 1.5% in LRN, p = 0.75), but MWA showed less renal function damage than LRN (p < 0.0001). The multivariate analysis showed the presence of postablation extrarenal metastasis may become a predictor of the oncologic outcome (p = 0.059) and treatment modality had no influence (p = 0.965). This study demonstrates that MWA and LRN provide comparable results in small RCC outcomes.

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Acknowledgments

This work was supported by three Grants 81430039, 81127006, and 81401436 from the National Scientific Foundation Committee of China, one Grant 7144246 from the Beijing Natural Science Foundation and supported from the State Key Laboratory of Kidney Diseases.

Conflict of interest

All authors have made a substantial contribution to the information or material submitted for publication. All have read and approved the final manuscript. All have no direct or indirect commercial financial incentive associated with publishing the article. The manuscript or portions thereof are not under consideration by another journal or electronic publication and have not been previously published.

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    Authors and Affiliations

    1. Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China

      Jie Yu, Ping Liang, Xiao-ling Yu, Zhi-gang Cheng, Zhi-yu Han, Meng-juan Mu & Xin Li

    2. Department of Cardiology, The General Hospital of Jinan Military Region, Jinan, 250031, China

      Guoming Zhang

    3. Department of Urology Surgery, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China

      Xu Zhang & Jun Dong

    4. Department of Ultrasound, Puyang Traditional Chinese Medicine Hospital of Henan Province, 135 Shengli East Road, Puyang, 457000, China

      Qin-ying Li

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    1. Jie Yu
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    Correspondence to Ping Liang.

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    Jie Yu and Guoming Zhang have contributed equally to the manuscript.

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    Yu, J., Zhang, G., Liang, P. et al. Midterm results of percutaneous microwave ablation under ultrasound guidance versus retroperitoneal laparoscopic radial nephrectomy for small renal cell carcinoma. Abdom Imaging 40, 3248–3256 (2015). https://doi.org/10.1007/s00261-015-0500-2

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    • DOI: https://doi.org/10.1007/s00261-015-0500-2

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