Abstract
Introduction
Percutaneous microwave ablation (MWA) of renal masses (RM) is still considered experimental
as opposed to established procedures such as cryoablation (CA). We aimed to compare
perioperative, functional and oncological outcomes of patients with RM treated with
CA and MWA.
Materials and Methods
Data from 116 (69.9%) and 50 (30.1%) patients treated with CA and MWA for RM were
analyzed. Patients’ demographics and perioperative data were collected including nephrometry
scores, complications, pre- and postprocedural renal function. Tumor persistence and
recurrence were recorded. Descriptive statistics compared functional outcomes between
groups. Cox regression analyses tested risk factors associated with recurrence.
Results
Groups were similar in terms of RM diameter, nephrometry scores and histology distribution.
Median follow-up was 26 (13-46) and 24 (14-36) months for CA and MWA, respectively.
The rate of overall (36.2% for CA vs. 24% for MWA, P= .1) and major (Clavien ≥ 3a) complications (1.7% vs. 5.4%, P = .1) were similar among groups. The median decline of renal function after 6 months
follow-up did not differ between CA and MWA (P = .8). Tumor persistence [4.3% vs. 12%] and recurrence [9.5% and 7.1%] rates were similar
for CA and MWA. Three years recurrence free and overall survival were 91% versus 95%
(log-rank P = .77) and 80 versus 88% (log-rank P = .23) in the CA and MWA groups, respectively. At Cox analysis no predictors were found
associated with recurrence.
Conclusion
Despite being considered still experimental, MWA showed comparable outcomes relative
to CA in terms of safety, preservation of renal function and oncological efficacy.
Keywords
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Article info
Publication history
Published online: July 14, 2022
Accepted:
July 9,
2022
Received in revised form:
June 29,
2022
Received:
April 24,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
