Nakada Stephen Y, Jerde Travis J, Warner Thomas, Lee Fred T
Department of Surgery, Division of Urology, The University of Wisconsin Medical School, Madison, Wisconsin, USA.
BJU Int. 2004 Sep;94(4):632-6. doi: 10.1111/j.1464-410X.2004.05015.x.
To compare the efficacy of cryoablation and radical nephrectomy for treating implanted VX-2 carcinoma in rabbit kidneys.
A pilot study was conducted using 27 New Zealand white rabbits to assess the natural history of VX-2 carcinoma in the kidney. VX-2 tumour segments (1 mm(3)) were excised from subcutaneous tumours in carrier rabbits and implanted in the left kidney of study rabbits. The tumours were allowed to grow for 6, 7, 8, 9, 10, 14, 18, 21 and 28 days after implantation. Tumour progression was analysed in the kidney and surrounding serosa, and metastatic tumour presence in the lung, liver, spleen and bladder determined. After this, 80 rabbits were implanted with VX-2 in the lower pole and randomized into one of three groups: group 1, 35 rabbits treated 7 days after VX-2 implantation with cryoablation using a 15-min double-freeze technique and a 5-mm tumour margin target temperature of - 20 degrees C; group 2, 35 rabbits treated with open radical nephrectomy; or group 3, 10 untreated controls. Rabbits were maintained for 22 days and then killed; the kidneys, lungs, liver, spleen, urinary bladder and ureter were removed, and examined grossly and histologically for tumour presence.
In the pilot study there was a consistent 50-100 mm(3) tumour after 7 days of growth, with no evidence of metastatic disease. By day 10 the mean kidney tumour was 230 mm(3) and two of three rabbits had metastases in the lung. By day 18 the mean primary tumour was 5504 mm(3) and all rabbits had metastatic disease. In the comparison study, cryotherapy cured 66% of implanted rabbits while nephrectomy cured 64%. All untreated controls had significant local and metastatic tumours. Findings in animals killed at 15 days after treatment showed significant differences between both treatment groups and untreated controls (P < 0.002). There was no difference in disease-free survival between the cryotherapy and open nephrectomy groups (P = 0.78)
Both cryoablation and radical nephrectomy were effective in treating implanted VX-2 renal tumours compared with untreated controls. There was no statistically significant difference between cryoablation and nephrectomy.
比较冷冻消融术与根治性肾切除术治疗兔肾VX - 2移植癌的疗效。
采用27只新西兰白兔进行一项初步研究，以评估肾VX - 2癌的自然病程。从携带兔的皮下肿瘤中切取1立方毫米的VX - 2肿瘤组织块，植入研究兔的左肾。肿瘤植入后分别于6、7、8、9、10、14、18、21和28天观察其生长情况。分析肾脏及周围浆膜的肿瘤进展情况，并确定肺、肝、脾和膀胱中转移瘤的存在情况。此后，80只兔在肾下极植入VX - 2肿瘤，并随机分为三组：第1组，35只兔在VX - 2植入后7天采用15分钟双冻技术及5毫米肿瘤边缘-20℃的目标温度进行冷冻消融治疗；第2组，35只兔接受开放性根治性肾切除术；第3组，10只未治疗的对照兔。兔饲养22天后处死；取出肾脏、肺、肝、脾、膀胱和输尿管，进行大体和组织学检查以确定肿瘤是否存在。
在初步研究中，肿瘤生长7天后体积持续达到50 - 100立方毫米，无转移疾病证据。到第10天，平均肾肿瘤体积为230立方毫米，三只兔中有两只出现肺转移。到第18天，平均原发肿瘤体积为5504立方毫米，所有兔均出现转移疾病。在比较研究中，冷冻治疗使66%的植入兔治愈，肾切除术使64%的兔治愈。所有未治疗的对照兔均有明显的局部和转移肿瘤。治疗后15天处死动物的结果显示，两个治疗组与未治疗的对照组之间存在显著差异（P < 0.002）。冷冻治疗组与开放性肾切除组之间的无病生存率无差异（P = 0.78）。
与未治疗的对照组相比，冷冻消融术和根治性肾切除术治疗植入的VX - 2肾肿瘤均有效。冷冻消融术与肾切除术之间无统计学显著差异。
