UK: Microwave ablation (MWA) is a safe and effective treatment method and can be considered for the management of small renal masses in patients with suspected renal cell carcinoma (RCC), a recent study has found. The results are published in the journal BJU International.
Joseph B. John, The Royal Devon and Exeter NHS Foundation Trust, Exeter, UK, and colleagues reported a tertiary referral centre's experience of microwave ablation (MWA) for suspected renal cell carcinoma, describing complications and oncological outcomes.
For the purpose, the researchers maintained consecutive MWA procedures (n = 113) for renal masses on a prospective database. Data describing patient, disease, procedure, complications, and oncological outcomes were analysed. The median age was 68 years, 73% were male, and the median Charlson Comorbidity Index was 0.
Key findings of the study include:
The median (interquartile range [IQR]) tumour diameter was 25 mm.
In all, 95% had renal mass biopsy, with histologically confirmed cancer in 75%.
The median (IQR) R.E.N.A.L. (Radius, Exophytic/Endophytic, Nearness, Anterior/Posterior, Location) nephrometry score was 7 (6–8).
The median ablation time was 6 min and length of stay was 1 day for 95% of the patients. Clavien–Dindo complication Grades I, II, IIIb and IV occurred in 18%, 1.8%, 0.9% and 0.9%, respectively.
The median follow‐up was 12 months and the median (IQR) renal function change was −4%.
0.9% had local recurrence, treated with re‐ablation; two developed metastatic progression; and 1.8% had indeterminate findings on follow‐up (one lung nodule and one possible local recurrence), managed with ongoing protocolised computed tomography surveillance.
Post‐procedure complications were associated with total ablation time (odds ratio [OR] 1.152/min) and total ablation energy (OR 1.017/kJ).
"We describe the largest UK series of MWA treatment for T1a/small T1b renal masses to date. MWA was well tolerated, with 95% discharged the following day and low complication/re‐admission rates," wrote the authors. "Current follow‐up demonstrates favourable disease control. MWA appears to be safe and effective and should be considered in future prospective comparisons of treatments for T1a/small T1b renal masses."
Reference:
The study titled, "Percutaneous microwave ablation of renal masses in a UK cohort," is published in the journal BJU International.
DOI: https://bjui-journals.onlinelibrary.wiley.com/doi/abs/10.1111/bju.15224