Park Sangtae, Cadeddu Jeffrey A, Shingleton W Bruce
Department of Urology, LSU Health Sciences Center, 1501 Kings Hwy., Shreveport, LA 71103-4228, USA.
Curr Urol Rep. 2007 Jan;8(1):31-7. doi: 10.1007/s11934-007-0018-4.
Needle ablative therapies for small incidental renal masses are emerging as alternatives to traditional extirpative surgery. Reasons include their associated decreased morbidity, shorter convalescence, and the ability to avert the higher risk of extirpative surgery in an aging patient population. Cryoablation (CA) and radiofrequency ablation are the two most thoroughly studied needle ablative methods used for renal cancer. High-intensity focused ultrasound has also been studied but with limited published human experience at this time. For both radiofrequency ablation and CA, in vitro experiments, animal studies, and (increasingly) human experience have been published, allowing us to define appropriate candidates for such therapies, their oncologic outcomes, and the potential pitfalls. While long-term data is being collected, the current literature suggests that CA and radiofrequency ablation can be safely performed and can effectively eradicate small renal cancers with cancer-specific survival rates similar to those of traditional surgical options.
针对小的偶然发现的肾肿块的针消融疗法正在成为传统切除手术的替代方法。原因包括其相关的发病率降低、康复期缩短,以及能够避免在老年患者群体中进行切除手术的较高风险。冷冻消融(CA)和射频消融是用于肾癌的两种研究最充分的针消融方法。高强度聚焦超声也已得到研究,但目前已发表的人体经验有限。对于射频消融和CA,已经发表了体外实验、动物研究以及(越来越多的)人体经验,这使我们能够确定此类疗法的合适候选者、其肿瘤学结果以及潜在的陷阱。在收集长期数据的同时,当前文献表明,CA和射频消融可以安全地进行,并且能够有效根除小肾癌,其癌症特异性生存率与传统手术选择相似。