Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.
Department of Urology, University of Trieste, Cattinara Hospital - ASUGI, Trieste, Italy.
Clin Genitourin Cancer. 2022 Dec;20(6):e506-e511. doi: 10.1016/j.clgc.2022.07.004. Epub 2022 Jul 16.
Percutaneous microwave ablation (MWA) of renal masses (RM) is still considered experimental as opposed to established procedures such as cryoablation (CA). We aimed to compare perioperative, functional and oncological outcomes of patients with RM treated with CA and MWA.
Data from 116 (69.9%) and 50 (30.1%) patients treated with CA and MWA for RM were analyzed. Patients' demographics and perioperative data were collected including nephrometry scores, complications, pre- and postprocedural renal function. Tumor persistence and recurrence were recorded. Descriptive statistics compared functional outcomes between groups. Cox regression analyses tested risk factors associated with recurrence.
Groups were similar in terms of RM diameter, nephrometry scores and histology distribution. Median follow-up was 26 (13-46) and 24 (14-36) months for CA and MWA, respectively. The rate of overall (36.2% for CA vs. 24% for MWA, P= .1) and major (Clavien ≥ 3a) complications (1.7% vs. 5.4%, P = .1) were similar among groups. The median decline of renal function after 6 months follow-up did not differ between CA and MWA (P = .8). Tumor persistence [4.3% vs. 12%] and recurrence [9.5% and 7.1%] rates were similar for CA and MWA. Three years recurrence free and overall survival were 91% versus 95% (log-rank P = .77) and 80 versus 88% (log-rank P = .23) in the CA and MWA groups, respectively. At Cox analysis no predictors were found associated with recurrence.
Despite being considered still experimental, MWA showed comparable outcomes relative to CA in terms of safety, preservation of renal function and oncological efficacy.
与冷冻消融（CA）等既定程序相比，经皮微波消融（MWA）治疗肾肿瘤（RM）仍被认为是实验性的。我们旨在比较接受 CA 和 MWA 治疗的 RM 患者的围手术期、功能和肿瘤学结果。
分析了 116 例（69.9%）和 50 例（30.1%）接受 CA 和 MWA 治疗的 RM 患者的数据。收集了患者的人口统计学和围手术期数据，包括肾肿瘤评分、并发症、术前和术后肾功能。记录肿瘤的持续性和复发情况。对组间功能结果进行描述性统计比较。Cox 回归分析测试了与复发相关的风险因素。
两组在 RM 直径、肾肿瘤评分和组织学分布方面相似。CA 和 MWA 的中位随访时间分别为 26（13-46）和 24（14-36）个月。总体（CA 为 36.2%，MWA 为 24%，P=.1）和主要（Clavien ≥ 3a）并发症（1.7%对 5.4%，P=.1）的发生率在两组之间相似。6 个月随访后肾功能的中位下降在 CA 和 MWA 之间没有差异（P=.8）。CA 和 MWA 的肿瘤持续性[4.3%对 12%]和复发率[9.5%和 7.1%]相似。CA 和 MWA 组的 3 年无复发生存率和总生存率分别为 91%对 95%（对数秩 P=.77）和 80%对 88%（对数秩 P=.23）。在 Cox 分析中，没有发现与复发相关的预测因素。
尽管 MWA 被认为仍处于实验阶段，但在安全性、肾功能保护和肿瘤学疗效方面，与 CA 相比，MWA 显示出相似的结果。
