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Updated: Jul 18, 2025
Application of Microwave Ablation in Laparoscopic Partial Splenectomy
Published on: November 15, 2024
Comparison of microwave ablation and partial nephrectomy for T1a small renal masses
Jessica Qiu1, Christopher Ballantyne2, Moritz Lange1
1University of Virginia School of Medicine, Charlottesville, VA.
Objective:
To compare the oncological and renal function outcomes of microwave ablation (MWA) compared to partial nephrectomy (PN) in two small renal mass (SRM) tumor size cohorts, <3 cm and 3-4 cm.
Materials And Methods:
This study included retrospective data from 2009 to 2015 and prospective data since 2015 from a single-institution database. Patient demographics, renal mass characteristics, and treatment outcomes were collected. Survival curves and hazard analysis were used to assess oncological outcomes. Changes in eGFR and CKD stage following surgery were used to assess renal function outcomes.
Results:
A total of 80 PN and 126 MWA patients were analyzed. Median age and Charlson Comorbidity Index (CCI) of MWA patients were greater than PN for each tumor size cohort. Cumulative progression free survival at 36-months was 91% for MWA and 90% for PN. Preoperative renal function was significantly lower in patients undergoing MWA for both tumor sizes, however there was no significant difference in the postoperative change in renal function between MWA and PN for tumors up to 4 cm.
Conclusions:
Oncological outcomes and renal preservation were comparable between MWA and PN cohorts for SRMs <3cm and 3-4cm despite the MWA cohort being older and having more comorbidities. Our findings suggest that MWA can be used as a safe and effective alternative to PN for T1a renal tumors up to 4 cm.
Insights
Microwave ablation (MWA) and partial nephrectomy (PN) show similar oncological and renal outcomes for small renal masses up to 4 cm. MWA is a safe alternative, even in older patients with more comorbidities.
Area of Science:
- Urology
- Oncology
- Minimally Invasive Surgery
Background:
- Small renal masses (SRMs) are increasingly detected.
- Partial nephrectomy (PN) is the standard treatment for SRMs.
- Alternative ablative therapies are being explored for renal tumor management.
Purpose of the Study:
- To compare oncological and renal function outcomes of microwave ablation (MWA) versus partial nephrectomy (PN).
- To evaluate these outcomes in two small renal mass tumor size cohorts: <3 cm and 3-4 cm.
Main Methods:
- Retrospective and prospective data from a single institution (2009-present).
- Analysis of patient demographics, tumor characteristics, and treatment outcomes.
- Assessment of oncological outcomes using survival curves and hazard analysis.
- Evaluation of renal function changes (eGFR, CKD stage) post-treatment.
Main Results:
- 80 PN and 126 MWA patients were analyzed.
- MWA patients were older with higher Charlson Comorbidity Index (CCI).
- 36-month progression-free survival was 91% for MWA and 90% for PN.
- No significant difference in postoperative renal function change between MWA and PN for tumors up to 4 cm.
Conclusions:
- Oncological outcomes and renal preservation are comparable between MWA and PN for SRMs <3 cm and 3-4 cm.
- Microwave ablation (MWA) is a safe and effective alternative to partial nephrectomy (PN) for T1a renal tumors up to 4 cm.
- MWA offers a viable treatment option despite patient comorbidities.
