Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Int J Urol. 2009 Nov;16(11):869-73. doi: 10.1111/j.1442-2042.2009.02378.x. Epub 2009 Sep 3.
To report our results of percutaneous radiofrequency ablation (RFA) for renal tumors and to assess predictors of therapeutic efficacy.
Forty patients (median age 73 years) with renal tumors were treated with RFA under local or epidural anesthesia. All of them had high surgical risk or refused radical surgery. Tumors were punctured percutaneously using the Radionics Cool-tip RF System under computed tomography or ultrasonographic guidance. Median tumor diameter was 24 mm. After RFA, contrast-enhanced computed tomography or magnetic resonance imaging was performed within 1 month. Complete response (CR) was defined as no enhancement inside the tumor. Factors related to the outcome and to renal function were assessed.
Median follow up was 16 months. CR was observed in 34 cases (85.0%). A significant difference in CR rate was observed between tumors < or =30 mm and those >30 mm. Outcomes tended to be better for tumors in the mid to lower kidney, and those away from the renal hilum. Recurrence was observed in one case (2.9%), but a CR was obtained again by additional RFA. Out of a total of 77 RFA procedures, complications occurred in only three cases (3.9%), and conservative treatment was possible in all cases. Serum creatinine levels 3 months after RFA did not differ from those before RFA.
Percutaneous RFA is a safe and effective treatment for small renal tumors in patients with high surgical risk or who refuse radical surgery.
报告我们经皮射频消融（RFA）治疗肾肿瘤的结果，并评估治疗效果的预测因素。
40 例（中位年龄 73 岁）有肾肿瘤的患者在局部或硬膜外麻醉下接受 RFA 治疗。所有患者均有高手术风险或拒绝根治性手术。在计算机断层扫描或超声引导下，使用 Radionics Cool-tip RF 系统经皮穿刺肿瘤。肿瘤的中位直径为 24mm。RFA 后 1 个月内进行增强计算机断层扫描或磁共振成像检查。完全缓解（CR）定义为肿瘤内无增强。评估与结果和肾功能相关的因素。
中位随访时间为 16 个月。34 例（85.0%）观察到 CR。肿瘤≤30mm 和>30mm 的 CR 率有显著差异。肿瘤位于中肾至下肾、远离肾门的患者，结果往往更好。1 例（2.9%）复发，但再次行 RFA 获得 CR。77 例 RFA 手术中，仅 3 例（3.9%）出现并发症，所有病例均采用保守治疗。RFA 后 3 个月的血清肌酐水平与 RFA 前无差异。
经皮 RFA 是治疗高手术风险或拒绝根治性手术的小肾肿瘤的一种安全有效的方法。
