Percutaneous microwave ablation (MWA) has emerged as a new energy modality for percutaneous renal tumour ablation with potential advantages over radiofrequency and cryoablation. The goal of our study was to determine MWA outcomes for suspicious renal masses, with a subset analysis for biopsy-proven renal cell carcinoma (RCC) and larger (T1b) tumours.
Studies reporting outcomes of MWA for RCC were identified. Random effects models with inverse-variance weighting were used to pool outcomes, including technical success rate (TSR), technical efficacy rate (TER), local recurrence rate (LRR), cancer-specific survival rate (CSSR), overall survival rate (OSR), and complications.
Among 914 studies captured, 27 studies with 1584 patients (1683 malignant renal tumours) were included. The pooled TSR and TER were 99.6% (95% CI, 98.0-100%) and 96.2% (93.8-98.2%). The pooled LRR was 3.2% (1.9-4.7%). At 1, 3, and 5-years, the pooled CSSRs were 100% (99.4-100%), 100% (98.4-100%), and 97.7% (94.5-99.7%), while pooled OSRs were 99.0% (97.5-99.9%), 96.0% (93.1-98.3%), and 88.1% (80.3-94.2%). The pooled minor and major complication rates were 10.3% (7.1-13.9%) and 1.0% (0.3-2.1%). In 204 patients with 208 T1b tumours, the pooled TSR and TER were 100% (96.6-100%) and 85.2% (71.0-95.8%). The pooled LRR was 4.2% (0.9-8.9%). At 1, 3, and 5-years, the pooled CSSRs were 98.2% (88.7-100%), 97.2% (78.5-100%), and 98.1% (72.3-100%). At 1 and 3-years, the pooled OSRs were 94.3% (85.7-99.6%) and 89.3% (68.7-100%). The pooled minor and major complication rates were 14.8% (7.4-23.8%) and 2.6% (0-7.8%).
MWA demonstrated favorable short- to intermediate-term oncologic outcomes with low complication rates, including in the T1b subset, with moderate quality of data and heterogeneity of assessed outcomes. This supports MWA as a safe and effective treatment for RCC and a potential viable option for larger tumours.
Journal of endourology. 2023 Oct 11 [Epub ahead of print]
Jeremy Wu, Samir Sami, Katherine Lajkosz, Teruko Kishibe, Michael Ordon
University of Toronto Temerty Faculty of Medicine, 12366, Toronto, Ontario, Canada; ., St Michael's Hospital, 10071, Division of Urology, Department of Surgery, Toronto, Ontario, Canada; ., University Health Network, 7989, Toronto, Ontario, Canada; ., St Michael's Hospital Health Sciences Library, 532984, Toronto, Ontario, Canada; ., University of Toronto, 7938, Surgery, 61 Queen Street East, Suite 9-103, Toronto, Ontario, Canada, M5C 2T2; .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/37819699