Department of Urology, Dong-A University College of Medicine, Busan 602-714, Korea.
Korean J Radiol. 2012 Sep-Oct;13(5):625-33. doi: 10.3348/kjr.2012.13.5.625. Epub 2012 Aug 28.
To retrospectively evaluate the intermediate results of radiofrequency ablation (RFA) of small renal masses (SRMs).
Percutaneous or laparoscopic RFA was performed on 48 renal tumors in 47 patients. The follow-up studies included a physical examination, chest radiography, creatinine level, and contrast-enhanced CT or MRI. To confirm the pathologic criteria of complete ablation, 35 patients underwent a follow-up biopsy. Recurrence was defined as contrast enhancement on imaging studies after 3 months, lesion growth at subsequent imaging, or viable cancer cells on follow-up biopsy.
Technical success was achieved in 43 (89.6%) of 48 renal tumors. The mean tumor size was 2.3 cm and the mean follow-up period was 49.6 months. Repeated RFA was necessary in 5 tumors due to incomplete ablation. The overall complication rate was 35.8%, of which 96.2% were mild complications. Serum creatinine levels at 12 months after RFA did not differ from those before RFA (1.28 vs. 1.36 mg/dL). Four patients were found to have recurrence at various follow-up intervals, and distant metastasis was not found in any cases.
RFA appears to be a useful treatment for selected patients with SRMs. Our 4-year follow-up results disclose an excellent therapeutic outcome with RFA, while achieving effective local tumor control.
回顾性评估射频消融（RFA）治疗小肾肿瘤（SRM）的中期结果。
对 47 例 48 个肾肿瘤患者进行了经皮或腹腔镜 RFA。随访研究包括体格检查、胸部 X 线摄影、肌酐水平以及增强 CT 或 MRI。为了确认完全消融的病理标准，35 例患者接受了随访活检。复发定义为 3 个月后影像学研究显示对比增强、后续影像学上的病变生长或随访活检中发现存活的癌细胞。
48 个肾肿瘤中有 43 个（89.6%）达到了技术成功。肿瘤平均大小为 2.3cm，平均随访时间为 49.6 个月。由于不完全消融，5 个肿瘤需要重复 RFA。总的并发症发生率为 35.8%，其中 96.2%为轻度并发症。RFA 后 12 个月的血清肌酐水平与 RFA 前无差异（1.28 与 1.36mg/dL）。4 例患者在不同的随访间隔发现复发，未发现远处转移。
RFA 似乎是治疗选择的 SRM 患者的一种有效治疗方法。我们的 4 年随访结果显示 RFA 具有出色的治疗效果，同时实现了有效的局部肿瘤控制。
