Document Type
Presentation
Publication Date
4-12-2023
Abstract
Renal cell carcinomas (RCC) make up 80 to 85% of primary renal neoplasms. Over 90% are low grade and slow growing with low probability of metastasis. Advantages of percutaneous techniques including microwave ablation (MWA) over surgical approach such as partial nephrectomy (PN), including cost effectiveness, minimally invasive, better renal preservation rates, lower procedure-related morbidity, and reduced hospitalization time make the case compelling. The major limitations for MWA are lack of prospective RCT or long-term follow-up data. The objective of this capstone was to conduct a scoping review on MWA versus PN regarding oncologic, perioperative, and functional outcomes in the treatment of RCC. Database search included Embase, Ovid MEDLINE®, and the Cochrane Central Register of Controlled Trials for the period 2000 – 2020. Pre-specified PICOS criteria was used to identify studies relevant for inclusion, and eventually 5 studies were selected. The evidence showed that there was no difference in 5-year metastasis-free survival between MW and PN. The overall survival for PN at 3-years (97.9%) and 5 years (93.4%) was better than the overall survival for MWA at 3-year (95.2 %) and 5-years (87.2%). The median length of hospitalization was shorter for MWA compared to PN (2 days vs 6.5 days). Perioperative blood loss was significantly less for MWA vs PN (2 vs 8.1%), lower overall complications rate for MWA compared to PN (17.5% vs 24.3%) but higher major complication rate (6.1% vs 5.2%). Post-treatment eGFR decreased by a median of 2.34 for MWA compared to 2.04 for PN. In conclusion, this review shows that MWA is a safe and efficacious treatment for small-sized RCC with favorable results compared to PN, even better for some short-term outcomes. Comparative prospective MWA vs PN trials are needed to generate long-term data to establish equipoise and support the use of MWA.
Recommended Citation
Odumah, Benjamin, "A Scoping Review of Microwave Ablation Versus Partial Nephrectomy for Treatment of Renal Cell Carcinoma" (2023). Master of Science in Applied Health Economics and Outcomes Research Capstone Presentations. Presentation 28.https://jdc.jefferson.edu/msaheor/28
Language
English
