Microwave-induced thermoablation with Amica-probe is a safe and reproducible method to treat solid renal masses: results from a phase I study.
Microwave thermal ablation (MWTA) could be considered in the future for             treating small solid renal masses. The aim of the present study was to determine             both the tolerability of the new Amica-probe applicator-induced MWTA used in vivo             on patients with solid renal masses and the effects of heating on renal tumors             and normal renal parenchyma. Fourteen patients with renal masses eligible for             open radical nephrectomy were enrolled in this phase I study. All patients underwent             MWTA of renal masses during the open surgery procedure before clamping of renal             vascular pedicle. The effects of MWTA on patients' coagulation and tumor/renal             vasculature were investigated. The histological effects of MWTA on the tumor and             intralesional vital tumor cell skipping were also evaluated. The MWTA-induced             lesion diameters were measured to calculate both the overall ablation volume and             the lesion sphericity index (SI). The Clavien-Dindo classification was used. In             all patients the RENAL score was 9.4 (8-12) and the Charlson comorbidity index             was 4.8 (3-7). MWTA-induced lesion size was 44.14 mm (±22.59). Mean SI was 1.08             (±0.2). No significant differences among coagulation clinical parameters were             found. No local bleeding after MWTA treatment was reported. According to the Clavien-Dindo             classification, there were two grade II perioperative complications due to the             tumor extent but not related with the MWTA treatment. No residual vital tumor             cells inside the MWTA-induced lesions were found. Telephone interview at 27.4             (±4.2) months mean follow-up did not find any long-term adverse events due to             previous MWTA treatment. Amica-Probe applicator-induced MWTA is a safe and reproducible             method to treat solid renal masses.
Department of Urology, Santa Maria Annunziata Hospital, University of Florence, Florence, Italy.
Riccardo
R
Bartoletti
Enrico
E
Meliani
Alchiede
A
Simonato
Paolo
P
Gontero
Giovanna
G
Berta
Paolo
P
Dalla Palma
Elena
E
Leonardi
Tommaso
T
Cai
Giorgio
G
Carmignani
D055011:Ablation Techniques / Q000295:instrumentation / Q000379:methods*; D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods; D015203:Reproducibility of Results