Thermal ablation procedures represent an alternative treatment option for patients with T1a renal tumors. Radiofrequency ablation (RFA) and cryoablation (CA) are the most used and studied techniques, while microwave ablation (MWA) has progressively emerged in recent years.
Our aim was to assess the effectiveness and safety of MWA in comparison to RFA and CA for the treatment of primary renal tumors.
Pubmed, CENTRAL, Web of Science and Scopus were searched until March 2023 to identify studies aimed at comparing the efficacy and safety of MWA with those of RFA and CA for the treatment of patients with primary renal tumors. We compared MWA and RFA/CA primary technique efficacy, local recurrences, overall and cancer-specific survival, major and overall complications, and eGFR changes. Moreover, subgroup analyses were conducted (MWA vs RFA; MWA vs CA; MWA vs RFA/CA in T1a renal tumors).
Ten retrospective studies with 2258 thermal ablations were included (508 MWA and 1750 RFA /CA). MWA had fewer local recurrences (OR = 0.31; 95% CI, 0.16, 0.62; p = 0.0008) than RFA/CA; the other outcomes were not significantly different. In subgroup analyses, MWA resulted to have fewer overall complications than RFA (OR = 0.60; 95% CI, 0.38, 0.97; p = 0.04) and CA (OR = 0.49; 95% CI, 0.28, 0.85; p = 0.01); moreover, MWA was associated with fewer recurrences than CA (OR = 0.30; 95% CI, 0.11, 0.84; p = 0.02). In T1a renal tumors subgroup analysis, the outcomes were not significantly different.
MWA is an ablative procedure as effective and safe as RFA or CA for the treatment of renal tumors.
European journal of radiology. 2023 Jun 25 [Epub ahead of print]
Roberto Castellana, Massimiliano Natrella, Gianluca Fanelli, Valentina Lancellotta, Patrizia Cornacchione, Marco Castellana, Dimitrios Filippiadis, Luca Tagliaferri, Roberto Iezzi
Radiologia Diagnostica ed Interventistica, Ospedale Regionale "U. Parini", viale Ginevra 3, 11100 Aosta, Italy. Electronic address: ., Radiologia Diagnostica ed Interventistica, Ospedale Regionale "U. Parini", viale Ginevra 3, 11100 Aosta, Italy., Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia-Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy., Via Margherita di Savoia, 93, 70017 Putignano, Italy., Diagnostic and Interventional Radiology 2nd Radiology Dpt, University General Hospital "ATTIKON" Medical School, National and Kapodistrian University of Athens, 1 Rimini str, 12462 Haidari/Athens, Greece., Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia - Istituto di Radiologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A Gemelli 8, 00168 Rome, Italy.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/37392547