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Percutaneous microwave ablation therapy of renal cancer local relapse after radical nephrectomy: a feasibility and efficacy study

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Abstract

Renal cell carcinoma (RCC) local recurrence after radical nephrectomy is uncommon. When feasible, surgical removal remains the primary treatment strategy; nevertheless, local RCC relapse management is controversial, and less invasive procedures may represent an attractive option to achieve oncologic control. The aim of our study was to assess the feasibility, safety, and clinical outcomes of image-guided percutaneous microwave ablation (MWA) for RCC local recurrence in patients initially treated with nephrectomy with curative intent. 10 consecutive patients underwent CT-guided percutaneous MWA of a total of 10 retroperitoneal nodules. Inclusion criteria were: histologically verified retroperitoneal metastases, previous radical nephrectomy, lesion no larger than 3 cm, no other metastatic site elsewhere. All the procedures were performed under moderate sedation choosing the most favorable patient decubitus. If deemed necessary, pneumodissection was induced before ablation. After the antenna placement inside the target lesion, thermal ablation was achieved by maintenance of a power of 100 W for a total time between 2 and 4 min. All patients were observed overnight and discharged the following day if clinically stable. Technical success was obtained in 100% of patients. One patient was re-treated to complete oncologic response with repeat MWA. No major complications were observed. No patients demonstrated local recurrence at a mean follow-up of 26 months. MWA is a safe and effective treatment strategy for loco-regional relapse of RCC following radical nephrectomy. This technique may represent a valuable approach for patients who are not eligible for surgery.

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Unità Operativa Di Radiologia, Fondazione I.R.C.C.S. Cà Granda Ospedale Maggiore Policlinico, Milan, Italy

    Anna Maria Ierardi, Enrico Garanzini & Gianpaolo Carrafiello

  2. Department of Radiology, Sant’Anna University Hospital, Ferrara, Italy

    Aldo Carnevale

  3. Department of Radiological Area - Interventional Radiology Unit, E.O. Galliera Hospital, Mura Delle Cappuccine, 14, 16128, Genova, Italy

    Umberto G. Rossi

  4. Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, Sant’Orsola Hospital, University of Bologna, Bologna, Italy

    Matteo Renzulli & Rita Golfieri

  5. Department of Urology, ASST Santi Paolo E Carlo, San Paolo Hospital, University of Milan, Milan, Italy

    Nicola Macchione

  6. Department of Morphology, Surgery and Experimental Medicine, Section of Nuclear Medicine, University of Ferrara, Ferrara, Italy

    Corrado Cittanti

  7. Department of Morphology, Surgery and Experimental Medicine, Section of Radiology, University of Ferrara, Ferrara, Italy

    Melchiore Giganti

Authors
  1. Anna Maria Ierardi
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  2. Aldo Carnevale
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  3. Umberto G. Rossi
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  4. Matteo Renzulli
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  5. Enrico Garanzini
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  6. Rita Golfieri
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  7. Nicola Macchione
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  8. Corrado Cittanti
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  9. Melchiore Giganti
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  10. Gianpaolo Carrafiello
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Corresponding author

Correspondence to Anna Maria Ierardi.

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The authors declare that they have no conflict of interest.

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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. This study has obtained the Institutional Review Board (IRB) approval.

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Informed consent was obtained from all individual participants included in the study.

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Ierardi, A.M., Carnevale, A., Rossi, U.G. et al. Percutaneous microwave ablation therapy of renal cancer local relapse after radical nephrectomy: a feasibility and efficacy study. Med Oncol 37, 27 (2020). https://doi.org/10.1007/s12032-020-01354-0

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  • DOI: https://doi.org/10.1007/s12032-020-01354-0

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