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Percutaneous Microwave Ablation Versus Cryoablation in the Treatment of T1a Renal Tumors

  • Francesco De CobelliEmail author
  • Maurizio Papa
  • Marta Panzeri
  • Michele Colombo
  • Stephanie Steidler
  • Alessandro Ambrosi
  • Roberta Cao
  • Simone Gusmini
  • Paolo Marra
  • Umberto Capitanio
  • Roberto Bertini
  • Massimo Venturini
  • Andrea Losa
  • Franco Gaboardi
  • Francesco Montorsi
  • Gianpiero Cardone
Clinical Investigation Non-Vascular Interventions
Part of the following topical collections:
  1. Non-Vascular Interventions

Abstract

Purpose

Radiofrequency and cryoablation (Cryo) are the most widely used techniques for the treatment of T1a renal tumors in non-surgical candidates, yet microwave ablation (MWA) has been gaining popularity. In this study, we tested the hypothesis that MWA has comparable safety and efficacy to Cryo in the treatment of selected T1a renal masses.

Materials and Methods

A retrospective comparative analysis of two patient cohorts was carried out on 83 nodules in 72 consecutive patients treated using image-guided percutaneous ablation with either Cryo or MWA. Patient demographics, tumor histology and characteristics, technical success, procedure time, adverse events and complications, nephrometry score (mRENAL) and renal function were evaluated. Local recurrence was evaluated at 1, 6, 12 and 18–24 months.

Results

Fifty-one nodules were treated with Cryo and 32 with MWA (44 and 28 patients, respectively). No statistical differences were observed following Cryo or MWA in median tumor size (p = 0.6), mRENAL (p = 0.1) or technical success (p = 0.8). Median procedure time was significantly lower using microwave ablation (p = 0.003). Median follow-up time was similar in the two groups (22 and 20 months, respectively). Occurrence of complications did not differ (Cryo 5/51, MWA 2/32; p = 0.57), and probability of complications or technical success adjusted for mRENAL did not reach statistical significance (p = 0.6). Renal function was preserved in all patients regardless of techniques. Disease recurrence was observed in 3/47 and in 1/30 treated nodules in the Cryo and MWA groups, respectively, without reaching statistical significance (p = 0.06).

Conclusion

In the patient population studied, MWA showed comparable safety and efficacy relative to Cryo.

Level of Evidence

Level 3, Non-randomized cohort study.

Keywords

Microwave ablation Cryoablation T1a renal tumors Recurrence Safety Efficacy 

Notes

Funding

No funding supported this study.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have non conflict of interest.

Consent for Publication

Consent for publication was obtained within a specific ICF form.

Ethical Approval

Even though the study is retrospective, all procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards and approved by the Institutions’ Ethics Committee.

Informed Consent

Informed consent was obtained from all individual participants included in the study or waivered according to indications of the local Ethics Committee.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  • Francesco De Cobelli
    • 1
    • 2
    • 3
    Email author
  • Maurizio Papa
    • 4
  • Marta Panzeri
    • 1
  • Michele Colombo
    • 1
  • Stephanie Steidler
    • 1
  • Alessandro Ambrosi
    • 2
  • Roberta Cao
    • 1
  • Simone Gusmini
    • 1
  • Paolo Marra
    • 1
  • Umberto Capitanio
    • 5
    • 6
  • Roberto Bertini
    • 5
    • 6
  • Massimo Venturini
    • 1
  • Andrea Losa
    • 7
  • Franco Gaboardi
    • 7
  • Francesco Montorsi
    • 2
    • 5
    • 6
  • Gianpiero Cardone
    • 4
  1. 1.Department of RadiologyIRCCS Ospedale San RaffaeleMilanItaly
  2. 2.Vita Salute San Raffaele UniversityMilanItaly
  3. 3.Clinical and Experimental Radiology, Experimental Imaging CenterIRCCS Ospedale San RaffaeleMilanItaly
  4. 4.Department of RadiologyIRCCS Ospedale San Raffaele TurroMilanItaly
  5. 5.Department of UrologyIRCCS Ospedale San RaffaeleMilanItaly
  6. 6.Division of Experimental OncologyUrological Research Institute (URI), IRCCS Ospedale San RaffaeleMilanItaly
  7. 7.Department of UrologyIRCCS Ospedale San Raffaele TurroMilanItaly

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