Percutaneous microwave ablation of renal cell carcinoma is safe in patients with renal dysfunction

Abstract

Objectives: To present the clinical effect of microwave ablation (MWA) on renal cell carcinoma (RCC) of the patients with renal dysfunction, mainly focussing on the extent of renal tumour control and damage to the residual kidney function. Methods and materials: From 2006 to 2014, 19 tumours of 18 patients with renal dysfunction underwent percutaneous ultrasound-guided MWA in our institution. The tumour diameters range from 1.9 to 5.0 cm. The serum creatinine and urea levels of each patient pre-MWA, one day after MWA and the most recent occasion on record at our institution were collected. After MWA all the patients were followed up using contrast enhanced ultrasound (CEUS) and computed tomography (CT) or magnetic resonance imaging (MRI) at the first 1, 3 and 6 months and every six months thereafter. Patients were available for clinical and laboratory evaluations at a median follow-up time of 24.9 months (range from 3.5 to 85.9 months). The technical success, survival rates and complications were accessed. Results: Complete ablation was achieved in 19/19 (100%) lesions after 1 or 2 MWA sessions; 2/18(11.1%) patients died of other diseases. No severe complications occurred during MWA. After MWA no significant elevation of renal function was observed either in patients of CKD stage 1–3 or in patients of CKD stage 4–5. Conclusions: MWA is an effective and relatively safe treatment option for patients with renal tumour who also suffered from renal dysfunction. The complication rate is low, and excellent tumour control can be achieved with acceptable loss of residual renal function.