Image-guided thermal ablation is a safe and effective treatment for kidney cancer that achieves 68.5% overall survival and 87.6% local tumor control at 10 years, with minimal complications and the ability to delay or eliminate the need for systemic therapy in many patients.
- 10-year survival rates: 68.5% overall survival and 75.5% cancer-specific survival in 50 kidney cancer patients
- Local tumor control: 87.6% local tumor progression-free survival at 10 years with 99-100% technical success
- Safety profile: Only 9.9% adverse event rate with no procedure-related deaths, mostly mild pneumothoraces and pleural effusions
- Systemic therapy avoidance: 64% of patients never required chemotherapy or immunotherapy over 8-year mean follow-up
- Study scope: Analysis of 50 patients with 100 kidney cancer lesions treated between 2008-2019 with extended follow-up through 2023
Image-guided thermal ablation is safe and effective in patients with kidney cancer, with excellent long-term overall survival rates, according to a study published August 19 in the Journal of Vascular and Interventional Radiology.
A group at the University of California, Los Angeles evaluated outcomes of percutaneous thermal ablation among 50 patients with oligometastatic renal cell carcinoma, with findings suggesting the procedures can help improve patient management, noted lead author Daniel Kim, MD, and colleagues.
"Percutaneous image-guided thermal ablation of oligometastatic renal cell carcinoma is safe and effective, achieving excellent long-term survival and local control with minimal complications, offering a durable local treatment option that can delay the need for systemic therapy," the group wrote.
Oligometastatic renal cell carcinoma (omRCC) is defined as up to five measurable kidney cancer metastases. While prior studies have found that thermal ablation is effective with low toxicity, the reports have been on only three- to five-year outcomes, which is insufficient to establish long-term durability, the authors explained.
To bridge the gasp, the group analyzed all consecutive patients who underwent percutaneous image-guided thermal ablation for omRCC at their cancer center between 2008 and 2019, with follow-up through 2023. The cohort included 50 patients with 100 omRCC lesions treated across 91 procedures, with a mean follow-up of 8 ± 2.8 years.
According to the findings, primary and secondary technical success rates were 99% and 100%. The 10-year overall survival (OS) and cancer-specific survival (CSS) rates were 68.5% and 75.5%. The 10-year local tumor progression-free survival (LTPFS) rate was 87.6%, with no significant differences by tumor histology, size, disease location, or ablation energy.
The adverse event rate was 9.9% across 91 procedures, with two mild and seven moderate events, primarily pneumothoraces and pleural effusions, all resolving with or without chest tube placement, and no procedure-related mortality, the researchers reported.
"Image-guided TA of omRCC was safe and effective with excellent long-term OS, CSS, and LTPFS outcomes within 10 years," the group wrote.
The authors noted that 64% of patients in the study never required systemic treatment over a mean follow-up of eight years. By achieving durable local control with ablation, clinicians may be able to thus reserve systemic therapy for later disease progression, when it may be most needed, the authors suggested.
"For further work, multicenter prospective studies with larger and homogeneous patient populations are needed to validate these findings and further define the role of thermal ablation in omRCC," the authors concluded.
Read the full study here.
