Curry David, Yassin Musaab, Thwaini Ali, Pahuja Ajay, Alanbuki Ammar H, Rajan Thiagarajan Nambi, Loan Willie
Belfast City Hospital, Belfast, Northern Ireland.
Can J Urol. 2014 Feb;21(1):7135-40.
To present the oncological outcomes in a series of patients with cT1a renal cell carcinoma (RCC) treated with radiofrequency ablation (RFA) and its effect on the glomerular filtration rate (GFR).
Forty-five patients (48 renal units) treated at the Belfast City Hospital, over 4 years. Average age is 61.5 years (range 41-80). Eighteen patients (22 renal units) were included with American Society of Anesthesiologists (ASA) II and III. The rest were ASA I. Average tumor size was 2.63 cm (range 1.2 cm-6 cm). Renal function before and after RFA was recorded by means of the estimated glomerular filtration rate (eGFR) and the changes are presented. Oncological outcomes were established from follow up imaging. A satisfactory response was defined by disappearance or a persistence of non-enhancing lesion of smaller size at follow up. A partial response was defined by a persistent but non-enhancing similar size lesion. A failed response was defined by enlarging or persistently enhancing lesions.
Mean follow up was 30.6 months (4-60 months). A good response was found in 33 (74%) patients. A partial response was found in 3 (8%) patients and failed response was identified in 8 (18%) patients. The average reduction in eGFR was 11 mL/min. Two patients had a 50% reduction in their eGFR. No patient required dialysis following treatment.
RFA presents safe treatment choice for patients with RCC, particularly those that are high risk surgical candidates and those who refuse surgery. Short term results suggest good oncological outcomes and preservation of renal function.
介绍一系列接受射频消融(RFA)治疗的cT1a期肾细胞癌(RCC)患者的肿瘤学结局及其对肾小球滤过率(GFR)的影响。
45例患者(48个肾单位)在贝尔法斯特市医院接受了超过4年的治疗。平均年龄为61.5岁(范围41 - 80岁)。18例患者(22个肾单位)为美国麻醉医师协会(ASA)II级和III级。其余为ASA I级。平均肿瘤大小为2.63 cm(范围1.2 cm - 6 cm)。通过估算肾小球滤过率(eGFR)记录RFA前后的肾功能,并呈现其变化。通过随访影像学确定肿瘤学结局。随访时病变消失或持续存在且大小较小的无强化病变定义为满意反应。持续存在但大小相似的无强化病变定义为部分反应。病变增大或持续强化定义为反应失败。
平均随访时间为30.6个月(4 - 60个月)。33例(74%)患者反应良好。3例(8%)患者为部分反应,8例(18%)患者反应失败。eGFR平均降低11 mL/min。2例患者的eGFR降低了50%。治疗后无患者需要透析。
RFA是RCC患者安全的治疗选择,尤其是那些手术高风险候选者和拒绝手术的患者。短期结果表明肿瘤学结局良好且肾功能得以保留。