Long-Term Survival after Percutaneous Image-Guided Thermal Ablation of Oligometastatic Renal Cell Carcinoma

To evaluate the long-term overall survival (OS), cancer-specific survival (CSS), and local tumor progression-free survival (LTPFS) of patients who underwent percutaneous image-guided thermal ablation (TA) (cryoablation, microwave ablation, and radiofrequency ablation) of oligometastatic renal cell carcinoma (omRCC).

This study cohort included 50 patients (age, 64.6 years [SD ± 13.1]; 78% [39/50] men and 22% [11/50] women) who underwent image-guided TA for omRCC between 2008 and 2019. Accounting for patient demographics, tumor characteristics, and technical outcomes, the OS, CSS, and LTPFS were derived by Kaplan-Meier analysis. Subgroup analyses were performed to assess the impact of outcomes by target lesion size, histology, location, and thermal energy using the log-rank test. All adverse events were categorized with the Society of Interventional Radiology (SIR) classification scheme.

The study cohort comprised 100 omRCC lesions treated in 91 procedures, with a follow-up of up to 10 years (mean follow-up, 8.0 years [SD ± 2.8]). Primary and secondary technical success rates were 99% and 100%, respectively. The 10-year OS and CSS rates were 68.5% and 75.5%, respectively, with no significant difference between clear cell (P = .87) or nonclear cell (P = .52) histology. The 10-year LTPFS rate was 87.6% with no significant differences based on tumor histology (P = .47), size (P = .88), disease location (P = .72), or TA energy (P = .26). The adverse event rate of 9.9% (9/91) included 2 mild (2.2%) and 7 moderate (7.7%), mostly self-limited, events.

Image-guided TA of omRCC was safe and effective with excellent long-term OS, CSS, and LTPFS outcomes within 10 years.