An Updated Systematic Review and Meta-Analysis on the Technical, Oncologic, and Safety Outcomes of Microwave Ablation in Patients with Renal Cell Carcinoma
Abstract
Introduction: Percutaneous microwave ablation (MWA) has emerged as a new energy modality for percutaneous renal tumor ablation with potential advantages over radiofrequency and cryoablation. The goal of our study was to determine MWA outcomes for suspicious renal masses, with a subset analysis for biopsy-proven renal cell carcinoma (RCC) and larger (T1b) tumors. Methods: Studies reporting outcomes of MWA for RCC were identified. Random-effects models with inverse-variance weighting were used to pool outcomes, including technical success rate (TSR), technical efficacy rate (TER), local recurrence rate (LRR), cancer-specific survival rate (CSSR), overall survival rate (OSR), and complications. Results: Among 914 studies captured, 27 studies with 1584 patients (1683 malignant renal tumors) were included. The pooled TSR and TER were 99.6% (95% confidence interval [CI], 98.0%–100%) and 96.2% (95% CI, 93.8%–98.2%). The pooled LRR was 3.2% (95% CI, 1.9%–4.7%). At 1, 3, and 5 years, the pooled CSSRs were 100% (95% CI, 99.4%–100%), 100% (95% CI, 98.4%–100%), and 97.7% (95% CI, 94.5%–99.7%), while pooled OSRs were 99.0% (95% CI, 97.5%–99.9%), 96.0% (95% CI, 93.1%–98.3%), and 88.1% (95% CI, 80.3%–94.2%). The pooled minor and major complication rates were 10.3% (95% CI, 7.1%–13.9%) and 1.0% (95% CI, 0.3%–2.1%). In 204 patients with 208 T1b tumors, the pooled TSR and TER were 100% (95% CI, 96.6%–100%) and 85.2% (95% CI, 71.0%–95.8%). The pooled LRR was 4.2% (95% CI, 0.9%–8.9%). At 1, 3,…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,584 participants or records.
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