Midterm results of percutaneous microwave ablation under ultrasound guidance versus retroperitoneal laparoscopic radial nephrectomy for small renal cell carcinoma.

Laparoscopic radial nephrectomy (LRN) and microwave ablation (MWA) are optional treatment for renal cell carcinoma (RCC). However, the comparative study with two techniques remains lacking. The aim of this study was to evaluate midterm results of MWA vs. LRN in patients with small RCC. A total of 426 patients with ≤ 4 cm RCC were included from April 2006 to October 2012. Ninety-eight patients underwent MWA and 328 patients LRN. The survival, recurrence, and renal function changes were compared between two treatments. Although overall survival after MWA (82.6% at 5 years) was lower than those after LRN (98.6% at 5 years, p = 0.0004), the RCC-related survival (97% at 5 years) was comparable to those following LRN (98% at 5 years, p = 0.38). One local tumor progress occurred at 32 months after MWA and none after LRN. The major complication rates were comparable between two techniques (1.7% in MWA vs. 1.5% in LRN, p = 0.75), but MWA showed less renal function damage than LRN (p < 0.0001). The multivariate analysis showed the presence of postablation extrarenal metastasis may become a predictor of the oncologic outcome (p = 0.059) and treatment modality had no influence (p = 0.965). This study demonstrates that MWA and LRN provide comparable results in small RCC outcomes.