Mp56-09 Microwave Ablation vs. Active Surveillance for Ct1a Small Renal Masses

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV (MP56)1 May 2024MP56-09 MICROWAVE ABLATION VS. ACTIVE SURVEILLANCE FOR CT1A SMALL RENAL MASSES Aisha O. Kazeem, Jessica X. Qiu, Theodore Vasiliadis, Emmett Kennady, Grant Lardieri, Wendy Qi, Guofen Yan, Moritz Lange, Laiba Murad, Chris Nelms, Christopher Ballantyne, Clinton Yeaman, Katherina Chen, Stephen Culp, Tracey Krupski, Noah Schenkman, and Jennifer Lobo Aisha O. KazeemAisha O. Kazeem , Jessica X. QiuJessica X. Qiu , Theodore VasiliadisTheodore Vasiliadis , Emmett KennadyEmmett Kennady , Grant LardieriGrant Lardieri , Wendy QiWendy Qi , Guofen YanGuofen Yan , Moritz LangeMoritz Lange , Laiba MuradLaiba Murad , Chris NelmsChris Nelms , Christopher BallantyneChristopher Ballantyne , Clinton YeamanClinton Yeaman , Katherina ChenKatherina Chen , Stephen CulpStephen Culp , Tracey KrupskiTracey Krupski , Noah SchenkmanNoah Schenkman , and Jennifer LoboJennifer Lobo View All Author Informationhttps://doi.org/10.1097/01.JU.0001008940.44711.d4.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Nephron-sparing surgery (NSS) is standard treatment for cT1a small renal masses (SRM) as it balances oncological outcomes and renal function preservation. While active surveillance (AS) is a viable option for c1Ta SRM in appropriately selected patients with elevated risk for extirpative surgical intervention, there is a relative paucity of data on long-term oncologic and renal function outcomes compared to NSS. Of the options for NSS, microwave ablation (MWA) is often offered to patients with significant co-morbidities and surgical risk. Therefore, we sought to compare characteristics and outcomes for patients with cT1a SRMs managed with AS, MWA, or delayed intervention (DI) defined as patients on AS progressing to NSS treatment. METHODS: Our institutional database was queried retrospectively for patients with cT1a SRM (≤ 4 cm) managed with MWA, AS, or DI from 2013-2023. Patient and tumor characteristics were collected, along with renal function data and peri-operative complications. Kaplan Meier analysis was performed for overall survival, metastasis free survival, and for progression-free survival for AS patients progressing to DI. RESULTS: A total of 221 patients were included, with 95 treated with AS, 112 with MWA, and 14 with DI (Table 1). Median follow-up for AS was 22 months (IQR 11.5-46.5), with a significant difference between DI and MWA patients (12 vs. 25.5 months, p=0.043). Median initial tumor size was significantly different between AS and MWA patients (2.0 vs. 2.8 cm, p<0.001) as well as MWA and DI patients (2.8 vs. 1.6 cm, p<0.001). Charlson Comorbidity Index (CCI) was greater in AS compared to MWA patients (5 vs. 4, p=0.0024). There was no difference in renal function decline or complications between treatments. When comparing AS vs MWA, there was no difference in metastasis free survival (p=0.24) or overall survival (p=0.18). Within the AS cohort, subgroup analysis comparing tumors <3 cm to 3-4 cm showed no difference in progression-free survival (p=0.56). CONCLUSIONS: We compared AS to MWA as both treatments are especially suited for older patients with significant co-morbidities. Our data showed no statistically significant differences in overall and metastasis free survival between the two treatments, suggesting that AS is a safe management option for appropriate patients with cT1a small renal masses. Source of Funding: NIH R01 1R01CA284057-01 "Optimizing Treatment Decision Making for Patients with Localized Renal Mass" © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e928 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Aisha O. Kazeem More articles by this author Jessica X. Qiu More articles by this author Theodore Vasiliadis More articles by this author Emmett Kennady More articles by this author Grant Lardieri More articles by this author Wendy Qi More articles by this author Guofen Yan More articles by this author Moritz Lange More articles by this author Laiba Murad More articles by this author Chris Nelms More articles by this author Christopher Ballantyne More articles by this author Clinton Yeaman More articles by this author Katherina Chen More articles by this author Stephen Culp More articles by this author Tracey Krupski More articles by this author Noah Schenkman More articles by this author Jennifer Lobo More articles by this author Expand All Advertisement PDF downloadLoading ...