Department of Radiology, Mayo Clinic, Rochester, Minnesota 55902, USA.
J Urol. 2010 Oct;184(4):1291-5. doi: 10.1016/j.juro.2010.06.003. Epub 2010 Aug 17.
We retrospectively determined the efficacy of percutaneous renal cryoablation based on a mean followup of more than 2 years.
Institutional review board approval was obtained for this Health Insurance Portability and Accountability Act compliant retrospective study. Informed consent was waived. From March 2003 through March 2007, 91 patients with 93 tumors underwent 92 percutaneous cryoablation procedures. Technical success was defined as extension of the ice ball beyond the tumor margin and post-ablation images showing no contrast enhancement in the area encompassing the original tumor within 3 months of the procedure. Local tumor progression was defined as new enhancement in the ablated tumor or an increase in ablated tumor size beyond 3 months after the procedure. Complications were defined using the National Cancer Institute Common Terminology Criteria for Adverse Events v3.0.
Mean followup was 26 months (range 5 to 61, SD ±13) and mean tumor size was 3.4 cm (range 1.5 to 7.3, SD ±1.2). Major complications occurred in 6 of 91 patients (7%) or after 8 of 92 (9%) procedures. Technically successful ablation was performed in the treatment of 89 of the 93 (96%) tumors or 87 of the 91 patients (96%). Of the 83 tumors with followup longer than 3 months only a single case (1%) of local tumor progression occurred. Overall local control was achieved in 86 of 91 (95%) patients or 88 of 93 (95%) tumors.
Midterm followup of percutaneous renal cryoablation shows durability of this treatment method with a low incidence of tumor recurrence beyond 3 months.
我们通过超过 2 年的平均随访,确定了经皮肾脏冷冻消融的疗效。
本研究符合《健康保险流通与责任法案》,获得了机构审查委员会的批准。豁免了知情同意。从 2003 年 3 月到 2007 年 3 月,91 名患者的 93 个肿瘤接受了 92 次经皮冷冻消融手术。技术成功定义为冰球超出肿瘤边缘,消融后 3 个月的图像在包含原始肿瘤的区域内没有对比增强。局部肿瘤进展定义为消融肿瘤内的新增强或消融肿瘤大小在手术后 3 个月后增加。并发症使用国家癌症研究所不良事件通用术语标准 v3.0 定义。
平均随访时间为 26 个月(范围 5 至 61,SD ± 13),平均肿瘤大小为 3.4cm(范围 1.5 至 7.3,SD ± 1.2)。91 名患者中有 6 名(7%)或 92 次手术中有 8 次(9%)发生了主要并发症。在 93 个肿瘤中有 89 个(96%)或在 91 名患者中有 87 个(96%)成功进行了技术上成功的消融治疗。在随访时间超过 3 个月的 83 个肿瘤中,只有 1 例(1%)出现局部肿瘤进展。91 名患者中有 86 名(95%)或 93 个肿瘤中有 88 名(95%)获得了总体局部控制。
经皮肾脏冷冻消融的中期随访结果显示,这种治疗方法的持久性较好,超过 3 个月后肿瘤复发的发生率较低。