SIR 2024
Interventional Oncology
Daniel H. Kim, MD
Medical Student
David Geffen School of Medicine at UCLA
Financial relationships: Full list of relationships is listed on the CME information page.
Lucia Chen, MS
Principal Statistician
David Geffen School of Medicine at UCLA
Disclosure information not submitted.
Alexandra Drakaki, MD, PhD
Professor
David Geffen School of Medicine
Disclosure information not submitted.
Brian Shuch, MD
Professor
David Geffen School of Medicine at UCLA
Disclosure information not submitted.
Allan Pantuck, MD
Professor
David Geffen School of Medicine at UCLA
Disclosure information not submitted.
Justin McWilliams, MD, FSIR
Professor of Interventional Radiology
David Geffen School of Medicine at UCLA
Financial relationships: Full list of relationships is listed on the CME information page.
David S. Lu, MD (he/him/his)
Professor of Radiology, and Surgery
David Geffen School of Medicine at UCLA
Disclosure information not submitted.
Steven Raman, MD, FSAR, FSIR
Professor of Radiology, Urology and Surgery
David Geffen School of Medicine At UCLA
Financial relationships: Full list of relationships is listed on the CME information page.
To determine the technical success (TS), long-term overall survival (OS), cancer-specific survival (CSS), and local tumor progression free survival (LTPFS) of patients who underwent percutaneous microwave ablation (MWA) of pathologically proven clear cell (ccRCC) and non-clear cell (nccRCC) renal cell carcinoma (RCC).
Materials and Methods:
This IRB-approved, HIPAA compliant study cohort (SC) included all patients who underwent percutaneous CT and contrast enhanced ultrasound (CEUS) guided MWA between 2013 and 2017 of biopsy-proven RCC. Patient demographics, tumor characteristics, procedural technical outcomes, and pre- and post-procedural estimated glomerular filtration rate (eGFR) were compiled and the TS, OS, CSS, and LTPFS were derived with Kaplan-Meier analysis and log-rank test to evaluate differences. Complications were classified per the Clavien-Dindo system. Logistic regression was used for categorical outcomes accounting for repeated measures at the lesion level, chi-square test was used for categorical outcomes excluding repeated measures at the patient level, and paired t-test was used for evaluating differences in eGFR.
Results:
The SC comprised 86 biopsy-proven RCCs (38/86 (44%) clear cell RCC) from 81 patients (mean age: 67.6 (28 – 94 years); men 62%) with a median follow-up of 76.8 months (1 to 123 months). Overall, primary (one session) and secondary (two sessions) TS were 100% (86/86), 88.4% (76/86) and 90% (9/10), respectively. The 5-year and 10-year OS, CSS, and LTPFS rates were 82.7% and 75.7%, 90.8% and 84.7%, and 84.3% and 82.9%, respectively. The T1b subcohort 8-year OS and LTPFS rates were lower compared to T1a subcohort (p=0.064, 0.005, respectively). RCC lesions > 4cm was predictive of LTPFS (p=0.016). The 8-year OS, CSS, LTPFS rates for the ccRCC and nccRCC subcohort were similar (p=0.47, 0.21, 0.64, respectively). The pre-ablation and 2-3 year post-ablation eGFR (58.5 vs 58.4 mL/min/1.73m2 were stable (p=0.932). There was a 2% overall incidence of complications, all grade I.
Conclusion:
Percutaneous CT and CEUS guided MWA of biopsy-proven ccRCC and nccRCC was safe and effective with excellent long-term OS, CSS, and LTPFS outcomes within 10 years from initial treatment for T1a and T1b lesions.