Percutaneous microwave ablation therapy of renal cancer local relapse after radical nephrectomy: a feasibility and efficacy study

Autor: Matteo Renzulli, Enrico Garanzini, Rita Golfieri, Aldo Carnevale, Anna Maria Ierardi, N. Macchione, Gianpaolo Carrafiello, Melchiore Giganti, Corrado Cittanti, Umberto G. Rossi
Přispěvatelé: Ierardi A.M., Carnevale A., Rossi U.G., Renzulli M., Garanzini E., Golfieri R., Macchione N., Cittanti C., Giganti M., Carrafiello G.
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Target lesion
Male
Cancer Research
Percutaneous
medicine.medical_treatment
Nephrectomy
Percutaneous ablation
0302 clinical medicine
Microwave thermal ablation
RCC recurrence
Renal cell carcinoma
Retroperitoneal relapse
Prospective Studies
Microwaves
Aged
80 and over
Microwave ablation
Kidney Neoplasm
Hematology
General Medicine
Ablation
Kidney Neoplasms
Treatment Outcome
Oncology
Surgery
Computer-Assisted
030220 oncology & carcinogenesis
Catheter Ablation
Female
medicine.symptom
Human
medicine.medical_specialty
NO
Lesion
03 medical and health sciences
medicine
Humans
Retroperitoneal Neoplasms
Carcinoma
Renal Cell
Aged
Retroperitoneal Neoplasm
business.industry
Cancer
medicine.disease
Surgery
Feasibility Studie
Prospective Studie
Feasibility Studies
Neoplasm Recurrence
Local
business
Tomography
X-Ray Computed
Microwave
Popis: Renal cell carcinoma (RCC) local recurrence after radical nephrectomy is uncommon. When feasible, surgical removal remains the primary treatment strategy; nevertheless, local RCC relapse management is controversial, and less invasive procedures may represent an attractive option to achieve oncologic control. The aim of our study was to assess the feasibility, safety, and clinical outcomes of image-guided percutaneous microwave ablation (MWA) for RCC local recurrence in patients initially treated with nephrectomy with curative intent. 10 consecutive patients underwent CT-guided percutaneous MWA of a total of 10 retroperitoneal nodules. Inclusion criteria were: histologically verified retroperitoneal metastases, previous radical nephrectomy, lesion no larger than 3cm, no other metastatic site elsewhere. All the procedures were performed under moderate sedation choosing the most favorable patient decubitus. If deemed necessary, pneumodissection was induced before ablation. After the antenna placement inside the target lesion, thermal ablation was achieved by maintenance of a power of 100W for a total time between 2 and 4min. All patients were observed overnight and discharged the following day if clinically stable. Technical success was obtained in 100% of patients. One patient was re-treated to complete oncologic response with repeat MWA. No major complications were observed. No patients demonstrated local recurrence at a mean follow-up of 26months. MWA is a safe and effective treatment strategy for loco-regional relapse of RCC following radical nephrectomy. This technique may represent a valuable approach for patients who are not eligible for surgery.
Databáze: OpenAIRE
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