Microwave ablation versus combined microwave ablation and transarterial chemoembolization for T1a renal cell carcinoma: a Single-Center retrospective study

This study aimed to evaluate and compare the clinical efficacy and renal function outcomes of microwave ablation (MWA) alone versus MWA combined with transarterial chemoembolization (MWA + TACE) in patients with T1a renal cell carcinoma (RCC), with a focus on tumor complexity as defined by RENAL nephrometry scores. In this retrospective single-center cohort study, 24 patients with T1a RCC were treated with either MWA (n = 14) or MWA + TACE (n = 10) between November 2020 and December 2024. Tumor response, residual enhancement rates, and renal function parameters were analyzed. RENAL scores were used to assess tumor complexity. Statistical comparisons between groups were performed using Student’s t-test and Fisher’s exact test. Patients treated with MWA + TACE had significantly higher RENAL scores than those treated with MWA (7.6 ± 1.6 vs. 6.1 ± 1.8; p = 0.03). Residual tumor enhancement was observed in 14.3% of patients in the MWA group, with no residual enhancement in the MWA + TACE group (p = 0.62). Post-procedural estimated glomerular filtration rate (eGFR) significantly declined in the MWA + TACE group (p = 0.04), while remaining stable in the MWA group (p = 0.39). MWA alone appears to be a safe and effective treatment option for T1a RCC, providing comparable tumor control to MWA + TACE without additional risk of renal function deterioration. Although TACE was applied to more anatomically complex tumors with higher RENAL scores, its addition did not significantly improve oncological outcomes but was associated with a notable decline in renal function.