Percutaneous Microwave Ablation for Treatment of Retroperitoneal Tumors

Annika E. Rossebo, Annie M. Zlevor, Emily A. Knott, Lu Mao, Allison B. Couillard, Timothy J. Ziemlewicz, J. Louis Hinshaw, E. Jason Abel, Meghan G. Lubner, Erica M. Knavel Koepsel, Shane A. Wells, Lindsay M. Stratchko, Paul F. Laeseke, Fred T. Lee

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Abstract

Purpose: To determine if microwave ablation (MWA) of retroperitoneal tumors can safely provide high rates of local tumor control. Materials and Methods: This retrospective study included 19 patients (median age, 65 years [range = 46–78 years]; 13 [68.4%] men and six [31.6%] women) with 29 retroperitoneal tumors treated over 22 MWA procedures. Hydrodissection (0.9% saline with 2% io-hexol) was injected in 17 of 22 (77.3%) procedures to protect nontarget anatomy. The primary outcomes evaluated were local tumor progression (LTP) and complication rates. Oncologic outcomes, including overall survival (OS), progression-free survival (PFS), and treatment-free interval (TFI), were examined as secondary outcome measures. Results: Median follow-up was 18 months (range = 0.5–113). Hydrodissection was successful in displacing nontarget anatomy in 16 of 17 (94.1%) procedures. The LTP rate was 3.4% (one of 29; 95% CI: 0.1, 17.8) per tumor and 5.3% (one of 19; 95% CI: 0.1, 26.0) per patient. The overall complication rate per patient was 15.8% (three of 19), including two minor complications and one major complication. The OS rate at 1, 2, and 3 years was 81.8%, 81.8%, and 72.7%, respectively, with a median OS estimated at greater than 7 years. There was no evidence of a difference in OS (P = .34) and PFS (P = .56) between patients with renal cell carcinoma (six of 19 [31.6%]) versus other tumors (13 of 19 [68.4%]) and patients treated with no evidence of disease (15 of 22 [68.2%]) versus patients with residual tumors (seven of 22 [31.8%]). Median TFI was 18 months (range = 0.5–108). Conclusion: Treatment of retroperitoneal tumors with MWA combined with hydrodissection provided high rates of local control, pro-longed systemic therapy−free intervals, and few serious complications.

Original languageEnglish (US)
Article numbere230080
JournalRadiology: Imaging Cancer
Volume6
Issue number2
DOIs
StatePublished - Mar 2024

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Oncology

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