Midterm results of percutaneous microwave ablation under ultrasound guidance versus retroperitoneal laparoscopic radial nephrectomy for small renal cell carcinoma.
Laparoscopic radial nephrectomy (LRN) and microwave ablation (MWA) are optional treatment for renal cell carcinoma (RCC). However, the comparative study with two techniques remains lacking. The aim of this study was to evaluate midterm results of MWA vs. LRN in patients with small RCC. A total of 426 patients with ≤ 4 cm RCC were included from April 2006 to October 2012. Ninety-eight patients underwent MWA and 328 patients LRN. The survival, recurrence, and renal function changes were compared between two treatments. Although overall survival after MWA (82.6% at 5 years) was lower than those after LRN (98.6% at 5 years, p = 0.0004), the RCC-related survival (97% at 5 years) was comparable to those following LRN (98% at 5 years, p = 0.38). One local tumor progress occurred at 32 months after MWA and none after LRN. The major complication rates were comparable between two techniques (1.7% in MWA vs. 1.5% in LRN, p = 0.75), but MWA showed less renal function damage than LRN (p < 0.0001). The multivariate analysis showed the presence of postablation extrarenal metastasis may become a predictor of the oncologic outcome (p = 0.059) and treatment modality had no influence (p = 0.965). This study demonstrates that MWA and LRN provide comparable results in small RCC outcomes.
Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. yu-jie301@hotmail.com.
Jie
J
Yu
Department of Cardiology, The General Hospital of Jinan Military Region, Jinan, 250031, China. syymail@hotmail.com.
Guoming
G
Zhang
Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. liangping301@hotmail.com.
Ping
P
Liang
Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. dyuxl301@yahoo.com.cn.
Xiao-ling
XL
Yu
Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. qlczg@hotmail.com.
Zhi-gang
ZG
Cheng
Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. hanzhiyu301@hotmail.com.
Zhi-yu
ZY
Han
Department of Urology Surgery, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. xzhang@foxmail.com.
Xu
X
Zhang
Department of Urology Surgery, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. jdong@medmail.com.cn.
Jun
J
Dong
Department of Ultrasound, Puyang Traditional Chinese Medicine Hospital of Henan Province, 135 Shengli East Road, Puyang, 457000, China. Lqy9915@163.com.
Qin-ying
QY
Li
Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. mumengjuan@yahoo.com.cn.
Meng-juan
MJ
Mu
Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. lixin301@hotmail.com.
Xin
X
Li
D055011:Ablation Techniques / Q000379:methods*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000503:physiopathology / Q000601:surgery; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000601:surgery*; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging; D008297:Male; D008872:Microwaves; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis*; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D055815:Young Adult
Laparoscopy; Microwave ablation; Nephrectomy; Renal cell carcinoma; Survival