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 machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.036 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.014 | 0.031 |
| Bibliometrics | 0.007 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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 source (direct Gemma or distilled Codex), 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".