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Percutaneous Microwave Ablation Versus Cryoablation in the Treatment of T1a Renal Tumors

  • Clinical Investigation
  • Non-Vascular Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

Radiofrequency and cryoablation (Cryo) are the most widely used techniques for the treatment of T1a renal tumors in non-surgical candidates, yet microwave ablation (MWA) has been gaining popularity. In this study, we tested the hypothesis that MWA has comparable safety and efficacy to Cryo in the treatment of selected T1a renal masses.

Materials and Methods

A retrospective comparative analysis of two patient cohorts was carried out on 83 nodules in 72 consecutive patients treated using image-guided percutaneous ablation with either Cryo or MWA. Patient demographics, tumor histology and characteristics, technical success, procedure time, adverse events and complications, nephrometry score (mRENAL) and renal function were evaluated. Local recurrence was evaluated at 1, 6, 12 and 18–24 months.

Results

Fifty-one nodules were treated with Cryo and 32 with MWA (44 and 28 patients, respectively). No statistical differences were observed following Cryo or MWA in median tumor size (p = 0.6), mRENAL (p = 0.1) or technical success (p = 0.8). Median procedure time was significantly lower using microwave ablation (p = 0.003). Median follow-up time was similar in the two groups (22 and 20 months, respectively). Occurrence of complications did not differ (Cryo 5/51, MWA 2/32; p = 0.57), and probability of complications or technical success adjusted for mRENAL did not reach statistical significance (p = 0.6). Renal function was preserved in all patients regardless of techniques. Disease recurrence was observed in 3/47 and in 1/30 treated nodules in the Cryo and MWA groups, respectively, without reaching statistical significance (p = 0.06).

Conclusion

In the patient population studied, MWA showed comparable safety and efficacy relative to Cryo.

Level of Evidence

Level 3, Non-randomized cohort study.

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Funding

No funding supported this study.

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Authors and Affiliations

  1. Department of Radiology, IRCCS Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy

    Francesco De Cobelli, Marta Panzeri, Michele Colombo, Stephanie Steidler, Roberta Cao, Simone Gusmini, Paolo Marra & Massimo Venturini

  2. Vita Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy

    Francesco De Cobelli, Alessandro Ambrosi & Francesco Montorsi

  3. Clinical and Experimental Radiology, Experimental Imaging Center, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy

    Francesco De Cobelli

  4. Department of Radiology, IRCCS Ospedale San Raffaele Turro, Via Stamina d’Ancona 32, 20154, Milan, Italy

    Maurizio Papa & Gianpiero Cardone

  5. Department of Urology, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy

    Umberto Capitanio, Roberto Bertini & Francesco Montorsi

  6. Division of Experimental Oncology, Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy

    Umberto Capitanio, Roberto Bertini & Francesco Montorsi

  7. Department of Urology, IRCCS Ospedale San Raffaele Turro, Via Stamina d’Ancona 32, 20154, Milan, Italy

    Andrea Losa & Franco Gaboardi

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  1. Francesco De Cobelli
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Correspondence to Francesco De Cobelli.

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Even though the study is retrospective, all procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards and approved by the Institutions’ Ethics Committee.

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De Cobelli, F., Papa, M., Panzeri, M. et al. Percutaneous Microwave Ablation Versus Cryoablation in the Treatment of T1a Renal Tumors. Cardiovasc Intervent Radiol 43, 76–83 (2020). https://doi.org/10.1007/s00270-019-02313-7

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