Microwave Thermal Ablation versus Open Partial Nephrectomy for the Treatment of Small Renal Tumors in Patients Over 70 Years Old
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
- Hollingsworth, J.M.; Miller, D.C.; Daignault, S.; Hollenbeck, B.K. Rising incidence of small renal masses: A need to reassess treatment effect. J. Natl. Cancer Inst. 2006, 98, 1331–1334. [Google Scholar] [CrossRef] [PubMed]
- Huang, W.C.; Levey, A.S.; Serio, A.M.; Snyder, M.; Vickers, A.J.; Raj, G.V.; Russo, P. Chronic kidney disease after nephrectomy in patients with renal cortical tumours: A retrospective cohort study. Lancet Oncol. 2006, 7, 735–740. [Google Scholar] [CrossRef]
- Zini, L.; Perrotte, P.; Capitanio, U.; Jeldres, C.; Shariat, S.F.; Antebi, E.; Karakiewicz, P.I. Radical versus partial nephrectomy: Effect on overall and noncancer mortality. Cancer 2009, 115, 1465–1471. [Google Scholar] [CrossRef] [PubMed]
- Zini, L.; Patard, J.J.; Capitanio, U.; Crepel, M.; de La Taille, A.; Tostain, J.; Villers, A. Cancer-specific and non-cancer-related mortality rates in European patients with T1a and T1b renal cell carcinoma. BJU Intern. 2009, 103, 894–898. [Google Scholar] [CrossRef] [PubMed]
- Carrafiello, G.; Mangini, M.; Fontana, F.; Recaldini, C.; Piacentino, F.; Pellegrino, C.; Fugazzola, C. Single-antenna microwave ablation under contrast-enhanced ultrasound guidance for treatment of small renal cell carcinoma: Preliminary experience. Cardiovasc. Interv. Radiol. 2010, 33, 367–374. [Google Scholar] [CrossRef] [PubMed]
- Castle, S.M.; Salas, N.; Leveillee, R.J. Initial experience using microwave ablation therapy for renal tumor treatment: 18-Month follow-up. Urology 2011, 77, 792–797. [Google Scholar] [CrossRef] [PubMed]
- Wells, S.A.; Wheeler, K.M.; Mithqal, A.; Patel, M.S.; Brace, C.L.; Schenkman, N.S. Percutaneous microwave ablation of T1a and T1b renal cell carcinoma: Short-term efficacy and complications with emphasis on tumor complexity and single session treatment. Abdom. Radiol. 2016, 41, 1203–1211. [Google Scholar] [CrossRef] [PubMed]
- De Baere, T.; Deschamps, F. New tumor ablation techniques for cancer treatment (microwave, electroporation). Diagn. Interv. Imaging 2014, 95, 677–682. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Levey, A.S.; Stevens, L.A.; Schmid, C.H.; Zhang, Y.L.; Castro, A.F.; Feldman, H.I.; Coresh, J. A new equation to estimate glomerular filtration rate. Ann. Intern. Med. 2009, 150, 604–612. [Google Scholar] [CrossRef] [PubMed]
- Maaravi, Y.; Bursztyn, M.; Hammerman-Rozenberg, R.; Cohen, A.; Stessman, J. Moderate renal insufficiency at 70 years predicts mortality. QJM Intern. J. Med. 2006, 99, 97–102. [Google Scholar] [CrossRef] [PubMed]
Variable | Open Partial Nephrectomy n = 18 (54.55%) | Microwave Thermal Ablation n = 15 (45.45%) | p Value |
---|---|---|---|
Median age (years) | 71.5 (IQR: 70–75) | 75 years (IQR: 71–79) | 0.005 |
Median body mass index (kg/m2) | 25 (IQR: 23–26) | 25 (IQR: 24–25) | 0.42 |
Median tumor diameter (cm) | 3 (IQR: 2.5–3.5) | 3.2 (IQR: 2.35–3.4) | 0.12 |
Median baseline glomerular filtration rate (mL/min/1.73 m2) | 46.2 (IQR: 42.7–65.8) | 59.9 (IQR: 49.5–73.8) | 0.12 |
Median baseline hemoglobin (g/L) | 134.5 (IQR: 124–140) | 125 (IQR: 108–138) | 0.45 |
Male/female | 10/8 | 9/6 | 0.55 |
Right/left | 8/10 | 6/9 | 0.76 |
ASA score | 11/7 | 5/10 | 0.71 |
1 | 4 | 1 | 0.62 |
2 | 13 | 9 | |
3 | 1 | 5 | |
Tumor location | 0.44 | ||
Upper | 5 | 3 | |
Middle | 4 | 8 | |
Lower | 9 | 4 | |
Charleston comorbidity index | 5.22 (IQR: 5–6) | 7.5 (IQR: 5–10) | 0.005 |
Histology | 0.56 | ||
Renal cell carcinoma | 15 | 12 | |
Papillary renal cell carcinoma | 2 | 1 | |
Chromophobe renal cell carcinoma | 1 | 2 | |
RENAL nefrometry score | 5 (IQR: 4–6) | 6 (IQR: 4.5–6) | 0.31 |
Variable | Open Partial Nephrectomy n = 18 (54.55%) | Microwave Thermal Ablation n = 15 (45.45%) | p Value |
---|---|---|---|
Median operation time (min) | 67.5 (IQR: 55–90) | 26 (IQR: 25–30) | <0.0001 |
Median hospital stay (d) | 9 (IQR: 7–11.5) | 3 (IQR: 2–3) | <0.0001 |
Median postoperative glomerular filtration rate (mL/min/1.73 m2) | 43.45 (IQR: 38.3–65) | 56.45 (IQR: 46.6–71.9) | 0.30 |
VAS scale | 4 (3–6) | 2 (1–3) | 0.008 |
Median postoperative hemoglobin (g/L) | 123.5 (IQR: 111–134) | 126 (IQR: 112–135) | 0.53 |
Difference of GFR (mL/min/1.73 m2) | −0.95 (IQR: −5.1–0) | −1.4 (IQR: −4.1–0.1) | 0.909 |
Difference of hemoglobin (g/L) | −4 (IQR: −22–1) | −1.5 (IQR: −3–1) | 0.110 |
Failure | 0 | 1 | 0.56 |
Median follow–up (months) | 40.10 (IQR: 38–43) | 40 (IQR: 34–47) | 0.56 |
Complications (major) | 0 | 0 | |
Recurrence of tumor | 0 | 0 | |
Metastasis | 0 | 0 |
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Anglickis, M.; Anglickienė, G.; Andreikaitė, G.; Skrebūnas, A. Microwave Thermal Ablation versus Open Partial Nephrectomy for the Treatment of Small Renal Tumors in Patients Over 70 Years Old. Medicina 2019, 55, 664. https://doi.org/10.3390/medicina55100664
Anglickis M, Anglickienė G, Andreikaitė G, Skrebūnas A. Microwave Thermal Ablation versus Open Partial Nephrectomy for the Treatment of Small Renal Tumors in Patients Over 70 Years Old. Medicina. 2019; 55(10):664. https://doi.org/10.3390/medicina55100664
Chicago/Turabian StyleAnglickis, Marius, Giedrė Anglickienė, Gintarė Andreikaitė, and Arminas Skrebūnas. 2019. "Microwave Thermal Ablation versus Open Partial Nephrectomy for the Treatment of Small Renal Tumors in Patients Over 70 Years Old" Medicina 55, no. 10: 664. https://doi.org/10.3390/medicina55100664