Renal cell carcinoma (RCC) local recurrence after radical nephrectomy is uncommon. When feasible, surgical removal remains the primary treatment strategy; nevertheless, local RCC relapse management is controversial, and less invasive procedures may represent an attractive option to achieve oncologic control. The aim of our study was to assess the feasibility, safety, and clinical outcomes of image-guided percutaneous microwave ablation (MWA) for RCC local recurrence in patients initially treated with nephrectomy with curative intent. 10 consecutive patients underwent CT-guided percutaneous MWA of a total of 10 retroperitoneal nodules. Inclusion criteria were: histologically verified retroperitoneal metastases, previous radical nephrectomy, lesion no larger than 3 cm, no other metastatic site elsewhere. All the procedures were performed under moderate sedation choosing the most favorable patient decubitus. If deemed necessary, pneumodissection was induced before ablation. After the antenna placement inside the target lesion, thermal ablation was achieved by maintenance of a power of 100 W for a total time between 2 and 4 min. All patients were observed overnight and discharged the following day if clinically stable. Technical success was obtained in 100% of patients. One patient was re-treated to complete oncologic response with repeat MWA. No major complications were observed. No patients demonstrated local recurrence at a mean follow-up of 26 months. MWA is a safe and effective treatment strategy for loco-regional relapse of RCC following radical nephrectomy. This technique may represent a valuable approach for patients who are not eligible for surgery.
Medical oncology (Northwood, London, England). 2020 Mar 13*** epublish ***
Anna Maria Ierardi, Aldo Carnevale, Umberto G Rossi, Matteo Renzulli, Enrico Garanzini, Rita Golfieri, Nicola Macchione, Corrado Cittanti, Melchiore Giganti, Gianpaolo Carrafiello
Unità Operativa Di Radiologia, Fondazione I.R.C.C.S. Cà Granda Ospedale Maggiore Policlinico, Milan, Italy. ., Department of Radiology, Sant'Anna University Hospital, Ferrara, Italy., Department of Radiological Area - Interventional Radiology Unit, E.O. Galliera Hospital, Mura Delle Cappuccine, 14, 16128, Genova, Italy., Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, Sant'Orsola Hospital, University of Bologna, Bologna, Italy., Unità Operativa Di Radiologia, Fondazione I.R.C.C.S. Cà Granda Ospedale Maggiore Policlinico, Milan, Italy., Department of Urology, ASST Santi Paolo E Carlo, San Paolo Hospital, University of Milan, Milan, Italy., Department of Morphology, Surgery and Experimental Medicine, Section of Nuclear Medicine, University of Ferrara, Ferrara, Italy., Department of Morphology, Surgery and Experimental Medicine, Section of Radiology, University of Ferrara, Ferrara, Italy.