Joint Bioengineering and Endourology Developmental Surgical Laboratory, Division of Endourology, Laparoscopy, and Minimally-Invasive Surgery, Department of Urology, University of Miami Miller School of Medicine, 1400 NW 10th Ave, Suite 509, Miami, FL 33136, USA.
World J Urol. 2010 Oct;28(5):583-91. doi: 10.1007/s00345-010-0562-2. Epub 2010 May 9.
Radiofrequency ablation (RFA) is increasingly finding a place in the treatment of small renal masses (SRM). RFA may be able to provide better renal preservation, while achieving appropriate cancer control. This investigation takes a critical look at pertinent aspects of RFA principles and reviews oncological and renal function outcomes.
A review of the most current English literature using a PubMed search was done. Oncological and renal function outcomes were reviewed from selected articles published between 2003 and 2009. Oncological outcome was determined by "single treatment" success rate at first follow-up and "After single treatment" success rate after first follow-up. Renal function outcome was determined by either change in creatinine, creatinine clearance, or GFR after RFA.
The mean tumor size was 2.5 cm for 16/17 studies. Average mean and median follow-up was 23.3 months in 13/17 studies and 19.8 months for 4/17 studies. "Single Treatment" success rates of 90-100% (average = 97.2%) were noted in 13 studies. Average increase in serum creatinine was +0.14 mg/dL in four studies. Serum creatinine and creatinine clearance change in one solitary kidney study was +11 mmol/L and -8 mL/min., respectively.
RFA is fast emerging as a safe and efficacious treatment for small renal masses. Compared to extirpative treatment options, RFA seems to provide the lowest rate of renal impairment, while providing acceptable rates of tumor ablation. As long-term results emerge, this may become one of the treatment modalities for renal tumors in patients with solitary kidneys and renal impairment.
射频消融术（RFA）在治疗小肾肿瘤（SRM）中的应用越来越广泛。RFA 可能能够提供更好的肾脏保存，同时实现适当的癌症控制。本研究对 RFA 原则的相关方面进行了批判性研究，并回顾了肿瘤学和肾功能结果。
使用 PubMed 搜索对最新的英文文献进行了回顾。从 2003 年至 2009 年发表的选定文章中回顾了肿瘤学和肾功能结果。肿瘤学结果通过首次随访时的“单次治疗”成功率和首次随访后的“单次治疗”后成功率来确定。肾功能结果通过 RFA 后肌酐、肌酐清除率或 GFR 的变化来确定。
16/17 项研究的平均肿瘤大小为 2.5cm。13/17 项研究的平均和中位数随访时间为 23.3 个月，4/17 项研究的随访时间为 19.8 个月。13 项研究中“单次治疗”成功率为 90-100%（平均为 97.2%）。四项研究中血清肌酐平均增加 0.14mg/dL。一项孤立肾研究中血清肌酐和肌酐清除率的变化分别为+11mmol/L 和-8mL/min。
RFA 作为小肾肿瘤的安全有效治疗方法迅速崭露头角。与切除术治疗方案相比，RFA 似乎提供了最低的肾功能损害率，同时提供了可接受的肿瘤消融率。随着长期结果的出现，这可能成为单肾和肾功能损害患者肾肿瘤的治疗方式之一。
