Atwell Thomas D, Farrell Michael A, Callstrom Matthew R, Charboneau J William, Leibovich Bradley C, Frank Igor, Patterson David E
Department of Radiology, Mayo Clinic, 200 1st St. SW, Rochester, MN 55902, USA.
AJR Am J Roentgenol. 2007 May;188(5):1195-200. doi: 10.2214/AJR.06.1152.
This retrospective study was performed to assess the feasibility, safety, and short-term outcome of percutaneous cryoablation of large solid renal tumors.
We reviewed 40 percutaneous cryoablation procedures performed on 40 patients with renal tumors 3 cm in diameter or larger. All patients underwent cryoablation with CT monitoring. Technical success was defined by extension of the ice ball beyond the tumor margin and postablation imaging findings of no contrast enhancement in the area encompassing the original tumor. Complications meeting grade 3 of the National Cancer Institute Common Terminology Criteria for Adverse Events were recorded.
Mean +/- SD tumor diameter was 4.2 +/- 1.1 cm (range, 3.0-7.2 cm). Technical success was achieved in 38 (95%) of 40 cryoablation procedures. There was one grade 3 adverse event (3% rate of significant complications). Follow-up images obtained 3 months or longer (mean, 9 +/- 6 months; range, 3-22 months) after ablation were available for 26 (65%) of the 40 patients. No local tumor recurrence or tumor progression was found.
Percutaneous cryoablation of renal tumors measuring 3 cm or larger is technically feasible and relatively safe. Short-term follow-up results are encouraging, although long-term follow-up is necessary to assess true treatment efficacy.
本回顾性研究旨在评估经皮冷冻消融治疗大型实性肾肿瘤的可行性、安全性及短期疗效。
我们回顾了对40例直径3厘米及以上肾肿瘤患者实施的40例经皮冷冻消融手术。所有患者均在CT监测下接受冷冻消融治疗。技术成功的定义为冰球超出肿瘤边缘，且消融后影像显示原肿瘤区域无对比增强。记录符合美国国立癌症研究所不良事件通用术语标准3级的并发症。
肿瘤平均直径±标准差为4.2±1.1厘米（范围3.0 - 7.2厘米）。40例冷冻消融手术中有38例（95%）取得技术成功。发生1例3级不良事件（严重并发症发生率为3%）。40例患者中有26例（65%）在消融后3个月或更长时间（平均9±6个月；范围3 - 22个月）获得随访影像。未发现局部肿瘤复发或肿瘤进展。
经皮冷冻消融治疗直径3厘米及以上的肾肿瘤在技术上可行且相对安全。短期随访结果令人鼓舞，不过仍需长期随访以评估真正的治疗效果。
