Kapoor Anil, Touma Naji J, Dib Regina El
Chair, GU Oncology Program, Juravinski Cancer Centre, Professor of Surgery (Urology), St. Joseph's Healthcare, McMaster University, Hamilton, ON;
Can Urol Assoc J. 2013 Jan-Feb;7(1-2):E38-44. doi: 10.5489/cuaj.12018.
Small renal masses are increasingly being discovered incidentally on imaging for another reason. The standard of care of these masses involves excision by open or laparoscopic techniques. Recently, ablative techniques, such as radiofrequency ablation (RFA) and cryoablation, have taken a more prominent role in the treatment algorithm of these masses. We evaluate the effectiveness and safety of cryoablation to treat renal tumours.
A review of the literature was conducted. There was no language restriction. Studies were obtained from the following sources: the Cochrane Library, PUBMED, EMBASE and LILACS.
There was no clinical trial identified in the literature. Thus, we described the results from 23 case series and retrospective studies with a reasonable sample size (number of reported patients in each study ≥30), with a total of 2104 analyzed tumours from 2038 patients. There was wide variability in the outcomes reported, but success rates were generally good. Follow-up was generally short, but some series reported outcomes at 5 years. The most common complications reported were hemorrhage (some of the patients requiring transfusion), perinephric hematoma and urine leaks.
Cryoablation presents a feasible treatment for patients with small renal masses. Only short-term data are available and, as such, meaningful conclusions regarding long-term cancer control cannot be made. More rigorous studies are needed.
小肾肿块越来越多地因其他原因在影像学检查中被偶然发现。这些肿块的治疗标准包括通过开放或腹腔镜技术进行切除。近来，诸如射频消融（RFA）和冷冻消融等消融技术在这些肿块的治疗方案中发挥了更突出的作用。我们评估冷冻消融治疗肾肿瘤的有效性和安全性。
进行了文献综述。没有语言限制。研究从以下来源获取：考克兰图书馆、PUBMED、EMBASE和LILACS。
文献中未发现临床试验。因此，我们描述了23个病例系列和回顾性研究的结果，这些研究样本量合理（每项研究报告的患者数量≥30），共分析了来自2038例患者的2104个肿瘤。报告的结果差异很大，但成功率总体良好。随访时间一般较短，但一些系列报告了5年的结果。报告的最常见并发症是出血（部分患者需要输血）、肾周血肿和尿漏。
冷冻消融是小肾肿块患者的一种可行治疗方法。目前仅有短期数据，因此无法得出关于长期癌症控制的有意义结论。需要更严格的研究。
