Erdeljan Petar, Dhar Mrinal, Wignall Geoff, Kozak Roman, Pautler Stephen E
Division of Urology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada.
Can J Urol. 2011 Oct;18(5):5903-7.
Cryoablation (CA) and radio frequency ablation (RFA) are nephron sparing procedures that destroy renal tissue in situ rather than by surgical removal. Both thermal ablative techniques are advocated in select patient population with a small renal mass and multiple comorbidities which may preclude major surgery. Unfortunately long term oncologic outcomes of these procedures are unknown.
We report oncologic outcomes following CA and RFA in patients with small renal masses, from a single center, during a 48 month follow up period. Thirty patients underwent thermal ablation of a small renal mass, 7 with RFA and 23 with CA.
Median tumor size on preoperative CT was 2.6 cm ± 0.87 cm. Four patients experienced a loco-regional treatment failure and underwent subsequent radical nephrectomy. Two patients were diagnosed with metastatic renal cell cancer in the follow up period. Six patients died during the follow up period, five from unrelated cause and one from metastatic RCC (overall survival 80%, RCC-specific survival 96%).
This study demonstrates low RCC recurrence rates and in combination with previously published reports supports the effectiveness of thermal ablation therapy as primary therapeutic option in a very specific patient population.
冷冻消融（CA）和射频消融（RFA）是保留肾单位的手术，它们在原位破坏肾组织，而非通过手术切除。这两种热消融技术适用于患有小肾肿瘤且伴有多种合并症、可能无法进行大手术的特定患者群体。不幸的是，这些手术的长期肿瘤学结果尚不清楚。
我们报告了单中心在48个月随访期内对小肾肿瘤患者进行CA和RFA后的肿瘤学结果。30例患者接受了小肾肿瘤的热消融，其中7例接受RFA，23例接受CA。
术前CT显示肿瘤大小中位数为2.6 cm±0.87 cm。4例患者出现局部区域治疗失败，随后接受了根治性肾切除术。2例患者在随访期间被诊断为转移性肾细胞癌。6例患者在随访期间死亡，5例死于无关原因，1例死于转移性肾细胞癌（总生存率80%，肾细胞癌特异性生存率96%）。
本研究显示肾细胞癌复发率较低，结合先前发表的报告，支持热消融治疗作为非常特定患者群体的主要治疗选择的有效性。
