AUA 2018: Comparative Analysis of Perioperative Outcomes for Patients With 4-7cm RCC Treated with Either Microwave Ablation, Partial Nephrectomy or Radical Nephrectomy

San Francisco, CA USA (UroToday.com) Daniel D. Shapiro of the University of Wisconsin School of Medicine and Public Health delivered a podium on their study looking at perioperative outcomes in patients with 4 – 7 cm renal cell carcinoma (RCC) tumors treated with either microwave ablation (MWA) or nephrectomy.

To do so, they performed a retrospective review of their institutional database of patients who underwent MWA, partial nephrectomy (PN), or radical nephrectomy (RN) for a 4 – 7 cm RCC tumor. They excluded those patients with metastases or venous thrombus.

Their final analytical cohort included 327 patients, including 42 (13%) for MWA, 74 (23%) for PN, and 211 (64%) for RN. The overall perioperative complications rate was 17%. There were 9 (21%), 18 (24%), and 28 (13%) complications in the MWA, PN, and RN cohorts, respectively. However, when compared to patients who underwent nephrectomy, those who received MWA were significantly older (p < 0.01) and had more comorbidities (p < 0.01). On multivariable Cox regression analysis, there were significantly increased risks of complications in those patients who had prior abdominal surgery (HR 2.27, 95% CI 1.21-4.26) or underwent PN (HR 2.42, 95% CI 1.23 – 4.76. They found no statistically significant difference in the rates of blood transfusion among the three treatment groups. They also found no statistically significant difference in the 30-day re-admission rate among the three treatment groups. Only one patient (from the RN cohort) died in the postoperative 30-day period.

The authors concluded that MWA is safe in patients with 4 – 7 cm RCC tumors, as the complications rate, 30-day re-admission rate, and perioperative mortality are comparable to those patients who underwent nephrectomy.

Presented by: Daniel D. Shapiro

Written by: Michael Owyong, Department of Urology, University of California-Irvine at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA
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