Mid-to-long term oncologic and functional outcomes of zero ischemia laparoscopic microwave ablation-assisted tumor enucleation for renal cell carcinoma: a single-center experience

BACKGROUND: Zero ischemia laparoscopic microwave ablation assisted tumor enucleation (MWA-TE) has been applied to renal cell carcinoma (RCC) treatment, but the mid-to-long term follow-up results are lacking. This study aims to evaluate the mid-to-long term oncological and functional consequences of MWA-TE in RCC treatment. METHODS: We conducted a retrospective analysis of 278 patients who received zero ischemia laparoscopic MWA-TE for RCC from March 2013 to June 2017. Peri- and post-operative data, renal functional and oncologic results were accumulated and evaluated. RESULTS: The median length of operation was 86 min, with an approximate median blood loss of 50 mL. The median estimated glomerular filtration rate (eGFR) prior to and 3 months post-operation was 90.6 [interquartile range (IQR), 65.2–116.0] and 83.6 (IQR, 52.4–114.8) mL/min/1.73 m(2), the median eGFR of the latest follow-up was 87.4 (IQR, 67.7–107.1) mL/min/1.73 m(2) and paired t-tests showed no significant difference between preoperative, post-operative and latest eGFR (P=0.069 and P=0.071). The median change in eGFR from before surgery to the latest follow-up was −2.82 mL/min/1.73 m(2). The median follow-up period was 39 months, and among all the patients, nine reported cancer recurrence or metastasis, the 3- and 5-year overall survival (OS) was 99.6% and 98.4%, respectively, and recurrence-free survival (RFS) was 98.2% and 95.8%, respectively. CONCLUSIONS: Zero ischemia laparoscopic MWA-TE is considered a feasible and effective nephron sparing surgical technique for selected renal tumors, and is accompanied by a low perioperative complication rate and promising mid-to-long term oncological and functional outcomes.