Long-Term Survival After Percutaneous Image-Guided Thermal Ablation of Oligometastatic Renal Cell Carcinoma.

PURPOSE: To evaluate the long-term overall survival (OS), cancer-specific survival (CSS), and local tumor progression-free survival (LTPFS) of patients who underwent percutaneous image-guided thermal ablation (TA) [cryoablation (CA), microwave ablation (MWA), and radiofrequency ablation (RFA)] of oligometastatic renal cell carcinoma (omRCC). MATERIALS AND METHODS: This study cohort included 50 patients (age: 64.6 ± 13.1 years; 78% (39/50) male, 22% (11/50) female) who underwent image-guided TA for omRCC between 2008 and 2019. Accounting for patient demographics, tumor characteristics, and technical outcomes, the OS, CSS, and LTPFS were derived by Kaplan-Meier analysis. Subgroup analyses were performed to assess the impact of outcomes by target lesion size, histology, location, and thermal energy using the log-rank test. All adverse events (AEs) were categorized with the Society of Interventional Radiology (SIR) classification scheme. RESULTS: The study cohort comprised 100 omRCC lesions treated in 91 procedures with follow-up to 10 years (mean follow-up: 8.0 ± 2.8 years). Primary and secondary technical success rates were 99% and 100%, respectively. The 10-year OS and CSS rates were 68.5% and 75.5%, respectively, with no significant difference between clear cell (p=0.87) or non-clear cell (p=0.52) histology. The 10-year LTPFS rate was 87.6% with no significant differences based on tumor histology (p=0.47), size (p=0.88), disease location (p=0.72), or TA energy (p=0.26). The AE rate of 9.9% (9/91) included two mild (2.2%) and seven moderate (7.7%), mostly self-limited events. CONCLUSION: Image-guided TA of omRCC was safe and effective with excellent long-term OS, CSS, and LTPFS outcomes within 10 years.