Urology Department, The Affiliated Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China.
Int J Urol. 2012 Mar;19(3):241-7. doi: 10.1111/j.1442-2042.2011.02918.x. Epub 2011 Nov 30.
The treatment of synchronous bilateral renal cell carcinoma is challenging. Radiofrequency ablation has been increasingly applied in the management of renal tumors. Herein, we report our experience of radiofrequency ablation on 12 patients with synchronous bilateral renal cell carcinoma.
From March 2006 to September 2010, 12 patients with bilateral synchronous sporadic renal cell carcinoma (29 lesions overall) were identified from our kidney database. The mean age was 62.3 years (range 35-81). The mean tumor diameter was 4.5 cm (range 0.9-9.0). Three patients received unilateral radiofrequency ablation and contralateral radical nephrectomy, whereas nine patients received bilateral radiofrequency ablation. The oncological and functional outcomes were analyzed. Contrast-enhanced computed tomography examinations were carried out at day 7, and at 3 and 6 months after the procedure, and every 6 months thereafter.
The mean follow-up period was 33 months (range 10-64). The local tumor control rate was 93.1% (27/29). Cancer-specific survival and the overall survival rates were 100%. No death or renal failure after the procedure was found. In patients who underwent bilateral radiofrequency ablation, the latest mean glomerular filtration rate had not significantly declined compared with preoperative levels (93.7 ± 13.0 mL/min/1.73 m(2) vs 96.9 ± 13.3 mL/min/1.73 m(2), respectively; P > 0.05).
Radiofrequency ablation shows encouraging outcomes in the treatment of bilateral renal cell carcinoma. It can provide adequate local tumor control and cancer-specific survival compared with nephron-sparing surgery while not affecting the renal function.
双侧同时性肾细胞癌的治疗颇具挑战性。射频消融术已越来越多地应用于肾肿瘤的治疗。本文报告了我们采用射频消融术治疗 12 例双侧同时性肾细胞癌的经验。
自 2006 年 3 月至 2010 年 9 月，我们从肾脏数据库中确定了 12 例双侧同时性散发性肾细胞癌（共 29 个病灶）患者。平均年龄为 62.3 岁（35-81 岁）。平均肿瘤直径为 4.5cm（0.9-9.0cm）。3 例患者接受单侧射频消融术和对侧根治性肾切除术，9 例患者接受双侧射频消融术。分析了肿瘤学和功能学结果。术后第 7 天、第 3 个月、第 6 个月及之后每 6 个月行增强 CT 检查。
平均随访时间为 33 个月（10-64 个月）。局部肿瘤控制率为 93.1%（27/29）。癌症特异性生存率和总生存率均为 100%。术后未出现死亡或肾衰竭。行双侧射频消融术的患者，其最新的平均肾小球滤过率与术前水平相比没有明显下降（93.7±13.0mL/min/1.73m2vs96.9±13.3mL/min/1.73m2，P＞0.05）。
射频消融术在双侧肾细胞癌的治疗中显示出令人鼓舞的结果。与保肾手术相比，它能提供充分的局部肿瘤控制和癌症特异性生存率，同时不影响肾功能。
