Percutaneous microwave ablation for local control of metastatic renal cell carcinoma

被引:9
作者
Maciolek, Kimberly A. [1 ]
Abel, E. Jason [2 ,3 ]
Best, Sara L. [2 ]
Emamekhoo, Hamid [4 ]
Averill, Sarah L. [3 ]
Ziemlewicz, Timothy J. [3 ]
Lubner, Meghan G. [3 ]
Hinshaw, J. Louis [2 ,3 ]
Lee, Fred T., Jr. [2 ,3 ]
Wells, Shane A. [3 ]
机构
[1] Univ Wisconsin, Sch Med & Publ Hlth, 600 Highland Ave,E3-376 Clin Sci Ctr, Madison, WI 53792 USA
[2] Univ Wisconsin, Sch Med & Publ Hlth, Dept Urol, 600 Highland Ave,E3-376 Clin Sci Ctr, Madison, WI 53792 USA
[3] Univ Wisconsin, Sch Med & Publ Hlth, Dept Radiol, 600 Highland Ave,E3-376 Clin Sci Ctr, Madison, WI 53792 USA
[4] Univ Wisconsin, Sch Med & Publ Hlth, Dept Human Oncol, 600 Highland Ave,E3-376 Clin Sci Ctr, Madison, WI 53792 USA
关键词
Renal cell carcinoma (RCC); Metastatic; RCC; Ablation; Microwave; Thermal; PULMONARY METASTASES; RESECTION; COMPLICATIONS; RADIOFREQUENCY; SURVIVAL; CRITERIA;
D O I
10.1007/s00261-018-1498-z
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
The purpose of the article is to evaluate the safety and oncologic efficacy of microwave ablation for metastatic renal cell carcinoma (mRCC). From September 2011 to December 2016, 33 mRCC were ablated in 18 patients using percutaneous microwave ablation. Sites of mRCC include retroperitoneum (n = 12), contralateral kidney (n = 6), liver (n = 6), lung (n = 5), adrenal gland (n = 5). Technical success, local, and distant tumor progression, and complications were assessed at immediate and follow-up imaging. The Kaplan-Meier method was used for survival analysis. Technical success was achieved for 33/33 (100%) mRCC tumors. Ablation provided durable local control for 28/30 (93%) mRCC tumors in 17 patients at a median duration of clinical and imaging follow-up of 1.6 years (IQR 0.7-3.6) and 0.8 years (IQR 0.5-2.7), respectively. In-hospital and perioperative mortality was 0%. There were 5 (15%) procedure-related complications including one high-grade event (Clavien-Dindo III). Four patients have died from mRCC at a median of 1.3 years (range 0.7-5.1) following ablation. Estimated OS (95% CI number still at risk) at 1, 2, and 5 years were 86% (53-96%, 11), 75% (39-92%, 8), and 75% (39-92%, 3), respectively. Microwave ablation of oligometastatic renal cell carcinoma is safe and provides durable local control in appropriately selected patients.
引用
收藏
页码:2446 / 2454
页数:9
相关论文
共 34 条
[1]   Image-Guided Tumor Ablation: Standardization of Terminology and Reporting Criteria-A 10-Year Update [J].
Ahmed, Muneeb ;
Solbiati, Luigi ;
Brace, Christopher L. ;
Breen, David J. ;
Callstrom, Matthew R. ;
Charboneau, J. William ;
Chen, Min-Hua ;
Choi, Byung Ihn ;
de Baere, Thierry ;
Dodd, Gerald D., III ;
Gervais, Debra A. ;
Gianfelice, David ;
Gillams, Alice R. ;
Lee, Fred T., Jr. ;
Leen, Edward ;
Lencioni, Riccardo ;
Littrup, Peter J. ;
Livraghi, Tito ;
Lu, David S. ;
McGahan, John P. ;
Meloni, Maria Franca ;
Nikolic, Boris ;
Pereira, Philippe L. ;
Liang, Ping ;
Rhim, Hyunchul ;
Rose, Steven C. ;
Salem, Riad ;
Sofocleous, Constantinos T. ;
Solomon, Stephen B. ;
Soulen, Michael C. ;
Tanaka, Masatoshi ;
Vogl, Thomas J. ;
Wood, Bradford J. ;
Goldberg, S. Nahum .
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2014, 25 (11) :1691-1705
[2]   Survival After Complete Surgical Resection of Multiple Metastases From Renal Cell Carcinoma [J].
Alt, Angela L. ;
Boorjian, Stephen A. ;
Lohse, Christine M. ;
Costello, Brian A. ;
Leibovich, Bradley C. ;
Blute, Michael L. .
CANCER, 2011, 117 (13) :2873-2882
[3]   Percutaneous Cryoablation of Stage T1b Renal Cell Carcinoma: Technique Considerations, Safety, and Local Tumor Control [J].
Atwell, Thomas D. ;
Vlaminck, Jay J. ;
Boorjian, Stephen A. ;
Kurup, Anil N. ;
Callstrom, Matthew R. ;
Weisbrod, Adam J. ;
Lohse, Christine M. ;
Hartman, William R. ;
Stockland, Andrew H. ;
Leibovich, Bradley C. ;
Schmit, Grant D. ;
Thompson, Robert H. .
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2015, 26 (06) :792-799
[4]   Pulmonary Thermal Ablation: Comparison of Radiofrequency and Microwave Devices by Using Gross Pathologic and CT Findings in a Swine Model [J].
Brace, Christopher L. ;
Hinshaw, J. Louis ;
Laeseke, Paul F. ;
Sampson, Lisa A. ;
Lee, Fred T., Jr. .
RADIOLOGY, 2009, 251 (03) :705-711
[5]   A NEW METHOD OF CLASSIFYING PROGNOSTIC CO-MORBIDITY IN LONGITUDINAL-STUDIES - DEVELOPMENT AND VALIDATION [J].
CHARLSON, ME ;
POMPEI, P ;
ALES, KL ;
MACKENZIE, CR .
JOURNAL OF CHRONIC DISEASES, 1987, 40 (05) :373-383
[6]   Prognostic factors associated with long-term survival in previously untreated metastatic renal cell carcinoma [J].
Choueiri, T. K. ;
Rini, B. I. ;
Garcia, J. A. ;
Baz, R. C. ;
Abou-Jawde, R. M. ;
Thakkar, S. G. ;
Elson, P. ;
Mekhail, T. M. ;
Zhou, M. ;
Bukowski, R. M. .
ANNALS OF ONCOLOGY, 2007, 18 (02) :249-255
[7]   Local treatments for metastases of renal cell carcinoma: a systematic review [J].
Dabestani, Saeed ;
Marconi, Lorenzo ;
Hofmann, Fabian ;
Stewart, Fiona ;
Lam, Thomas B. L. ;
Canfield, Steven E. ;
Staehler, Michael ;
Powles, Thomas ;
Ljungberg, Boerje ;
Bex, Axel .
LANCET ONCOLOGY, 2014, 15 (12) :E549-E561
[8]   Classification of surgical complications - A new proposal with evaluation in a cohort of 6336 patients and results of a survey [J].
Dindo, D ;
Demartines, N ;
Clavien, PA .
ANNALS OF SURGERY, 2004, 240 (02) :205-213
[9]  
Edge S.B., 2010, AJCC cancer staging manual, V649
[10]   Percutaneous High-Energy Microwave Ablation for the Treatment of Pulmonary Tumors: A Retrospective Single-Center Experience [J].
Egashira, Yoshiaki ;
Singh, Saurabh ;
Bandula, Steve ;
Illing, Rowland .
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2016, 27 (04) :474-479