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 ( 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