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Efficacy and Safety of MWA Versus RFA and CA for Renal Tumors: A Systematic Review and Meta-Analysis of Comparison Studies - Beyond the Abstract

Kidney cancer is one of the most common malignancies in men and women. Surgery is the preferred treatment for localized renal tumors. However, in selected subgroups of patients (e.g. elderly or comorbid patients unfit for surgery), a less invasive treatment with an ablative technique may be employed. These techniques include radiofrequency ablation (RFA), cryoablation (CA), and microwave ablation (MWA).

We conducted a systematic review and meta-analysis to evaluate the effectiveness and MWA compared to RFA and CA for treating primary renal tumors. Ten retrospective studies that included a total of 2,258 thermal ablations were found. The compared outcomes were primary technique efficacy, local recurrences, overall and cancer-specific survival, major and overall complications, and changes in estimated glomerular filtration rate (eGFR).

The results showed that MWA had fewer local recurrences compared to RFA/CA. However, there were no significant differences in the other outcomes examined. Subgroup analyses revealed that MWA had fewer overall complications compared to RFA and CA, individually. Additionally, MWA was associated with fewer recurrences compared to CA specifically. In the subgroup analysis focusing on T1a renal tumors, no significant differences in outcomes were observed.

Based on these findings, our meta-analysis concluded that MWA is an equally effective and safe ablative procedure for the treatment of renal tumors when compared to RFA and CA. However, it's important to note that several limitations were present and fully discussed in the study. Further research and randomized controlled trials may be needed to validate these findings and provide more robust evidence regarding the comparative effectiveness and safety of these ablative techniques.

Written by: Roberto Castellana,1 Massimiliano Natrella,2 Gianluca Fanelli,2 Valentina Lancellotta,3 Patrizia Cornacchione,3 Marco Castellana,4 Dimitrios Filippiadis,5 Luca Tagliaferri,3 Roberto Iezzi6

  1. Radiologia Diagnostica ed Interventistica, Ospedale Regionale "U. Parini", Aosta, Italy.
  2. Radiologia Diagnostica ed Interventistica, Ospedale Regionale "U. Parini", Aosta, Italy.
  3. Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia-Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  4. Via Margherita di Savoia, Putignano, Italy.
  5. Diagnostic and Interventional Radiology 2nd Radiology Dpt, University General Hospital "ATTIKON" Medical School, National and Kapodistrian University of Athens, Haidari/Athens, Greece.
  6. Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia - Istituto di Radiologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

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