REGULAR CONTENT
Final ID
464
Type
Original Scientific Research-Oral or Pos
Authors
W Zhou1, R Arellano2
Institutions
1Tufts University School of Medicine, Boston, MA, 2Massachusetts General Hospital, Boston, MA
Purpose
To assess technique, safety and short-term and clinical efficacy of percutaneous CT-guided microwave ablation (MWA) of renal cell carcinoma.
Materials & Methods
An IRB approved review of an Interventional Radiology database identified 39 patients with 44 RCC treated with MWA between October 2014 and August 2016. Patient and tumor demographics, and procedural data were collected; pre-and post MWA serum BUN, creatinine and eGFR were assessed by two-tailed student's t-test to assess changes in renal function. Technical success was defined as completion of planned MWA. Follow-up CT and MRI were reviewed to assess for complications and oncologic outcomes using RECIST criteria.
Results
There were 27 males and 12 females of mean age 68 years (range =55-88 yr). Mean tumor size was 2.5cm (1.4-6.9cm). Tumor subtypes were clear cell (28/44, 63%) and papillary, (13/44, 29%). Mean R.E.N.A.L nephrometry score was 6.1 (SD=2), mean P.A.D.U.A nephrometry score was 7.6 (SD=1.8), mean centrality C-index score was 3.03 (SD=1.5). Mean power used was 55W (SD=18W), mean ablation time was 8 minutes (SD=4.6); 12/44 (24%) tumors required ≥2 overlapping ablations. No significant changes were observed between pre- and post-ablation eGFR (p=0.24), creatinine (p=0.65), and BUN (p=0.40). Technical success was achieved for 100% of the tumors. There were 4/44 (10%) Clavien-Dindo grade I-II complications (SIR minor complication B), all perinephric hematomas that did not require transfusion. Mean follow-up was 3 months (range = 1-9 months). Complete response was achieved in 42/44 (95%) of tumors. Partial response was achieved in 2/44(5%) tumors; both considered high risk based on renal morphometry scores (mean R.E.N.A.L score=9, mean P.A.D.U.A = 10.5, C-index =1.36). Repeat MWA achieved complete response. There was no local tumor progression during the imaging follow-up time. All but one patient (98%) are alive and disease-free; one patient died 8 months post-MWA from causes unrelated to RCC.
Conclusions
CT-guided MWA appears to be safe, well tolerated and effective for patients with RCC. Prospective intermediate and long-term studies are necessary to establish long-term outcomes of MWA compared to other ablative therapies.
Final ID
464
Type
Original Scientific Research-Oral or Pos
Authors
W Zhou1, R Arellano2
Institutions
1Tufts University School of Medicine, Boston, MA, 2Massachusetts General Hospital, Boston, MA
Purpose
To assess technique, safety and short-term and clinical efficacy of percutaneous CT-guided microwave ablation (MWA) of renal cell carcinoma.
Materials & Methods
An IRB approved review of an Interventional Radiology database identified 39 patients with 44 RCC treated with MWA between October 2014 and August 2016. Patient and tumor demographics, and procedural data were collected; pre-and post MWA serum BUN, creatinine and eGFR were assessed by two-tailed student's t-test to assess changes in renal function. Technical success was defined as completion of planned MWA. Follow-up CT and MRI were reviewed to assess for complications and oncologic outcomes using RECIST criteria.
Results
There were 27 males and 12 females of mean age 68 years (range =55-88 yr). Mean tumor size was 2.5cm (1.4-6.9cm). Tumor subtypes were clear cell (28/44, 63%) and papillary, (13/44, 29%). Mean R.E.N.A.L nephrometry score was 6.1 (SD=2), mean P.A.D.U.A nephrometry score was 7.6 (SD=1.8), mean centrality C-index score was 3.03 (SD=1.5). Mean power used was 55W (SD=18W), mean ablation time was 8 minutes (SD=4.6); 12/44 (24%) tumors required ≥2 overlapping ablations. No significant changes were observed between pre- and post-ablation eGFR (p=0.24), creatinine (p=0.65), and BUN (p=0.40). Technical success was achieved for 100% of the tumors. There were 4/44 (10%) Clavien-Dindo grade I-II complications (SIR minor complication B), all perinephric hematomas that did not require transfusion. Mean follow-up was 3 months (range = 1-9 months). Complete response was achieved in 42/44 (95%) of tumors. Partial response was achieved in 2/44(5%) tumors; both considered high risk based on renal morphometry scores (mean R.E.N.A.L score=9, mean P.A.D.U.A = 10.5, C-index =1.36). Repeat MWA achieved complete response. There was no local tumor progression during the imaging follow-up time. All but one patient (98%) are alive and disease-free; one patient died 8 months post-MWA from causes unrelated to RCC.
Conclusions
CT-guided MWA appears to be safe, well tolerated and effective for patients with RCC. Prospective intermediate and long-term studies are necessary to establish long-term outcomes of MWA compared to other ablative therapies.