Microwave Ablation for Renal Cell Carcinoma: A Literature Review and Clinical Insights
Microwave ablation is an effective treatment modality for T1a and selected T1b renal cell carcinoma (RCC). Independent of the type of thermal ablation techniques used, there are important technical considerations for the successful destruction of targeted tumours while minimising complications, inc...
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| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Medical Journal
2025-04-01
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| Series: | EMJ Radiology |
| Online Access: | https://www.emjreviews.com/radiology/article/microwave-ablation-for-renal-cell-carcinoma-a-literature-review-and-clinical-insights/ |
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| Summary: | Microwave ablation is an effective treatment modality for T1a and selected T1b renal cell carcinoma (RCC). Independent of the type of thermal ablation techniques used, there are important technical considerations for the successful destruction of targeted tumours while minimising complications, including the use of ultrasound for antenna placement and ablation monitoring, immediate post-procedure contrast-enhanced CT for detection of incomplete treatment and early detection of complications, and hydrodissection and hydroureter for prevention of intraprocedural complications. A review of the existing clinical literature demonstrates a low rate of local tumour progression (LTP) following microwave ablation, aswell as a shorter hospitalisation and potentially fewer complications compared to surgery. However, not all patients are candidates for microwave ablation, which can be user-dependent and technically challenging. Overall, microwave ablation is a valuable modality for the minimally invasive treatment of RCC. The purpose of this article is to summarise the literature concerning microwave ablation of RCC with comparisons to other thermal ablation techniques, as well as partial and radical nephrectomy. Technical and clinical considerations are also discussed, with an emphasis on antenna placement, hydrodissection, imaging guidance, and follow-up. Key Points 1. Thermal ablation is a recommended first-line treatment for the management of small renal masses and is considered a viable treatment alternative for larger renal masses in patients who are not good surgical candidates. 2. In a narrative review of the current literature, microwave ablation is shown to be an excellent choice for the treatment of certain cases of renal cell carcinoma due to minimal invasiveness, preservation of renal function, and excellent oncologic outcomes. 3. Many of the limitations of microwave ablation such as risk of thermal injury to surrounding structures, collecting system, ureteral injuries, and incomplete treatment, can be mitigated with appropriate techniques, including the use of hydrodissection, pyeloperfusion, and real-time monitoring with ultrasound. |
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| ISSN: | 2633-9978 |