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经皮肾冷冻消融术:治疗115例肿瘤的经验

Percutaneous renal cryoablation: experience treating 115 tumors.

作者信息

Atwell Thomas D, Farrell Michael A, Leibovich Bradley C, Callstrom Matthew R, Chow George K, Blute Michael L, Charboneau J William

机构信息

Department of Radiology, Mayo Clinic, Rochester, Minnesota 55902, USA.

出版信息

J Urol. 2008 Jun;179(6):2136-40; discussion 2140-1. doi: 10.1016/j.juro.2008.01.144.

Abstract

PURPOSE

We determined technical feasibility, safety and short-term outcomes following percutaneous renal cryoablation.

MATERIALS AND METHODS

We performed a retrospective review of 115 renal tumors in 110 patients treated with percutaneous cryoablation. Specific attention was directed to tumor characteristics, hospital course, complications, technical success and treatment success based on followup imaging.

RESULTS

Mean tumor size was 3.3 cm (range 1.5 to 7.3), including 29 tumors 4.0 cm or larger and 21 tumors in the anterior kidney. Of 90 renal mass biopsies performed 52 (58%) showed renal cell carcinoma. All patients were admitted to the hospital following cryoablation and most (87%) were discharged home the next day (range 1 to 12 days). There were 7 major complications associated with the 113 cryoablation procedures (6%). Technical success was achieved in 112 of the 115 (97%) treated tumors and 3 residual tumors were seen on 3-month followup imaging. There has been no local progression in 80 tumors (100% treatment success) followed 3 months or longer (mean 13.3 months).

CONCLUSIONS

Percutaneous renal cryoablation is technically feasible and relatively safe. With experience many anterior tumors and tumors larger than 4 cm can be successfully treated. Long-term followup remains necessary to prove treatment durability.

摘要

目的

我们确定了经皮肾冷冻消融术后的技术可行性、安全性及短期疗效。

材料与方法

我们对110例接受经皮冷冻消融治疗的患者的115个肾肿瘤进行了回顾性研究。基于随访影像学,特别关注肿瘤特征、住院过程、并发症、技术成功率及治疗成功率。

结果

肿瘤平均大小为3.3厘米(范围1.5至7.3厘米),包括29个4.0厘米或更大的肿瘤以及21个位于肾前部的肿瘤。在90例肾肿块活检中,52例(58%)显示为肾细胞癌。所有患者在冷冻消融术后均入院,大多数(87%)于次日(范围1至12天)出院。113例冷冻消融手术中有7例发生主要并发症(6%)。115个接受治疗的肿瘤中有112个(97%)技术成功,在3个月的随访影像学检查中发现3个残留肿瘤。80个随访3个月或更长时间(平均13.3个月)的肿瘤无局部进展(治疗成功率100%)。

结论

经皮肾冷冻消融在技术上是可行的且相对安全。随着经验的积累,许多位于肾前部的肿瘤及大于4厘米的肿瘤能够成功治疗。仍需长期随访以证实治疗的持久性。

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