Journal of vascular and interventional radiology : JVIR · 2026
Oncologic Outcomes of Microwave Ablation of Biopsy-Proven cT1a Renal Cell Carcinomas.
СтатьяНазвание и аннотация: Перевод в очереди
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Strasser Mary Oakley, LaRussa Samuel, Dreyfuss Leo, Nabavizadeh Behnam, McRae-Posani Bala, Lee Kyungmouk Steve, Schiffman Marc, Sullivan Brian, Currie Brian, Del Pizzo Joseph, McClure Timothy
Аннотация
PURPOSE: To evaluate oncologic outcomes for biopsy-proven cT1a renal cell carcinoma (RCC) treated with computed tomography (CT)-guided microwave ablation (MWA).
MATERIALS AND METHODS: Patients who underwent MWA from 2015 to 2022 for cT1a RCCs were retrospectively reviewed. Inclusion criteria included tumors <4 cm (T1a) and a pathologic diagnosis of RCC. Exclusion criteria included non-RCC pathologies, RCCs >4.0 cm, prior ablations, and known RCC syndromes. Postablation surveillance imaging occurred immediately in the procedure suite, at 3 months, and annually thereafter. Outcomes included local tumor progression and primary and secondary treatment effectiveness. Kaplan-Meier survival analyses were conducted, including local progression-free survival and all-cause mortality.
RESULTS: A total of 206 patients met inclusion criteria. Median tumor size was 2.1 cm (interquartile range [IQR], 1.6-2.7 cm) with median follow-up time of 27.0 months (IQR, 14.8-45.3 months). Six patients (2.9%) experienced disease progression after a median of 22.5 months (IQR, 16.3-34.0 months). Primary and secondary treatment effectiveness rates were 94.7% and 97%, respectively. Two patients (1.0%) developed metastases. At 24 months, freedom from local tumor progression, disease progression, and metastasis was 91.5%, cancer-specific survival was 100%, and all-cause mortality rate was 4.9%. The adverse event (AE) rate was 3.3%. Four AEs (1.9%) with Common Terminology Criteria for Adverse Events (CTCAE) were Grade III or higher, including 1 case of ipsilateral ureteral obstruction requiring temporary stent placement and 2 perinephric hematomas requiring intervention with angiogram (n = 1, 0.4%) or embolization (n = 1, 0.4%).
CONCLUSIONS: MWA is a safe and effective treatment for patients with cT1a RCCs.
MATERIALS AND METHODS: Patients who underwent MWA from 2015 to 2022 for cT1a RCCs were retrospectively reviewed. Inclusion criteria included tumors <4 cm (T1a) and a pathologic diagnosis of RCC. Exclusion criteria included non-RCC pathologies, RCCs >4.0 cm, prior ablations, and known RCC syndromes. Postablation surveillance imaging occurred immediately in the procedure suite, at 3 months, and annually thereafter. Outcomes included local tumor progression and primary and secondary treatment effectiveness. Kaplan-Meier survival analyses were conducted, including local progression-free survival and all-cause mortality.
RESULTS: A total of 206 patients met inclusion criteria. Median tumor size was 2.1 cm (interquartile range [IQR], 1.6-2.7 cm) with median follow-up time of 27.0 months (IQR, 14.8-45.3 months). Six patients (2.9%) experienced disease progression after a median of 22.5 months (IQR, 16.3-34.0 months). Primary and secondary treatment effectiveness rates were 94.7% and 97%, respectively. Two patients (1.0%) developed metastases. At 24 months, freedom from local tumor progression, disease progression, and metastasis was 91.5%, cancer-specific survival was 100%, and all-cause mortality rate was 4.9%. The adverse event (AE) rate was 3.3%. Four AEs (1.9%) with Common Terminology Criteria for Adverse Events (CTCAE) were Grade III or higher, including 1 case of ipsilateral ureteral obstruction requiring temporary stent placement and 2 perinephric hematomas requiring intervention with angiogram (n = 1, 0.4%) or embolization (n = 1, 0.4%).
CONCLUSIONS: MWA is a safe and effective treatment for patients with cT1a RCCs.