An Updated Systematic Review and Meta-Analysis on the Technical, Oncologic, and Safety Outcomes of Microwave Ablation in Patients with Renal Cell Carcinoma
Bibliographic record
Abstract
Introduction:Percutaneous microwave ablation (MWA) has emerged as a new energy modality for percutaneous renal tumor ablation with potential advantages over radiofrequency and cryoablation. The goal of our study was to determine MWA outcomes for suspicious renal masses, with a subset analysis for biopsy-proven renal cell carcinoma (RCC) and larger (T1b) tumors. Methods:Studies reporting outcomes of MWA for RCC were identified. Random-effects models with inverse-variance weighting were used to pool outcomes, including technical success rate (TSR), technical efficacy rate (TER), local recurrence rate (LRR), cancer-specific survival rate (CSSR), overall survival rate (OSR), and complications. Results:Among 914 studies captured, 27 studies with 1584 patients (1683 malignant renal tumors) were included. The pooled TSR and TER were 99.6% (95% confidence interval [CI], 98.0%–100%) and 96.2% (95% CI, 93.8%–98.2%). The pooled LRR was 3.2% (95% CI, 1.9%–4.7%). At 1, 3, and 5 years, the pooled CSSRs were 100% (95% CI, 99.4%–100%), 100% (95% CI, 98.4%–100%), and 97.7% (95% CI, 94.5%–99.7%), while pooled OSRs were 99.0% (95% CI, 97.5%–99.9%), 96.0% (95% CI, 93.1%–98.3%), and 88.1% (95% CI, 80.3%–94.2%). The pooled minor and major complication rates were 10.3% (95% CI, 7.1%–13.9%) and 1.0% (95% CI, 0.3%–2.1%). In 204 patients with 208 T1b tumors, the pooled TSR and TER were 100% (95% CI, 96.6%–100%) and 85.2% (95% CI, 71.0%–95.8%). The pooled LRR was 4.2% (95% CI, 0.9%–8.9%). At 1, 3, and 5 years, the pooled CSSRs were 98.2% (95% CI, 88.7%–100%), 97.2% (95% CI, 78.5%–100%), and 98.1% (95% CI, 72.3%–100%). At 1 and 3 years, the pooled OSRs were 94.3% (95% CI, 85.7%–99.6%) and 89.3% (95% CI, 68.7%–100%). The pooled minor and major complication rates were 14.8% (95% CI, 7.4%–23.8%) and 2.6% (95% CI, 0%–7.8%). Conclusions:MWA demonstrated favorable short- to intermediate-term oncologic outcomes with low complication rates, including in the T1b subset, with moderate quality of data and heterogeneity of assessed outcomes. This supports MWA as a safe and effective treatment for RCC and a potential viable option for larger tumors.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.009 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".