Abstract
Introduction:
Percutaneous microwave ablation (MWA) has emerged as a new energy modality for percutaneous renal tumor 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) tumors.
Methods:
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.
Results:
Among 914 studies captured, 27 studies with 1584 patients (1683 malignant renal tumors) were included. The pooled TSR and TER were 99.6% (95% confidence interval [CI], 98.0%–100%) and 96.2% (95% CI, 93.8%–98.2%). The pooled LRR was 3.2% (95% CI, 1.9%–4.7%). At 1, 3, and 5 years, the pooled CSSRs were 100% (95% CI, 99.4%–100%), 100% (95% CI, 98.4%–100%), and 97.7% (95% CI, 94.5%–99.7%), while pooled OSRs were 99.0% (95% CI, 97.5%–99.9%), 96.0% (95% CI, 93.1%–98.3%), and 88.1% (95% CI, 80.3%–94.2%). The pooled minor and major complication rates were 10.3% (95% CI, 7.1%–13.9%) and 1.0% (95% CI, 0.3%–2.1%). In 204 patients with 208 T1b tumors, the pooled TSR and TER were 100% (95% CI, 96.6%–100%) and 85.2% (95% CI, 71.0%–95.8%). The pooled LRR was 4.2% (95% CI, 0.9%–8.9%). At 1, 3, and 5 years, the pooled CSSRs were 98.2% (95% CI, 88.7%–100%), 97.2% (95% CI, 78.5%–100%), and 98.1% (95% CI, 72.3%–100%). At 1 and 3 years, the pooled OSRs were 94.3% (95% CI, 85.7%–99.6%) and 89.3% (95% CI, 68.7%–100%). The pooled minor and major complication rates were 14.8% (95% CI, 7.4%–23.8%) and 2.6% (95% CI, 0%–7.8%).
Conclusions:
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 tumors.
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