Johnson Scott, Pham Khanh N, See William, Begun Frank P, Langenstroer Peter
Department of Urology, Medical College of Wisconsin, Milwaukee, WI.
Department of Urology, Medical College of Wisconsin, Milwaukee, WI.
Urology. 2014 Sep;84(3):613-8. doi: 10.1016/j.urology.2014.03.055.
To report the long-term oncologic outcomes of laparoscopic cryoablation for clinical stage T1 renal masses at the Medical College of Wisconsin.
A retrospective chart review was performed evaluating patients who underwent laparoscopic cryoablation for renal masses at the Medical College of Wisconsin between February 2000 and October 2009.
A total of 171 renal masses in 144 patients were treated by laparoscopic cryoablation during the study period. After excluding patients with <5 years follow-up and those with >clinical stage I disease, 112 renal masses treated in 92 patients remained for analysis. Mean patient age was 59.6 years (standard deviation [SD], 12.5 years). Mean lesion size was 2.3 cm (SD, 0.94 cm). Mean age adjusted Charlson comorbidity index was 4.55 (SD, 1.69). Mean follow-up was 97.9 months (SD, 24.8 months). Overall survival among all patients was 80.9%. Lesions were biopsy proven to be malignant in 70 patients (76.3%). Of those with biopsy-proven malignancy, there were 6 recurrences, 14 non-cancer-related deaths, and 1 cancer-related death, leading to an overall survival of 77.6%, progression-free survival of 91.0%, and cancer-specific survival of 98.5%.
We report the largest published series of laparoscopic renal cryoablation with the longest follow-up. Our series indicates that laparoscopic cryoablation is both an efficacious treatment for clinical stage T1 renal masses and provides excellent long-term oncologic outcomes.
报告威斯康星医学院对临床分期为T1期肾肿块进行腹腔镜冷冻消融的长期肿瘤学结局。
进行一项回顾性图表审查,评估2000年2月至2009年10月期间在威斯康星医学院接受腹腔镜冷冻消融治疗肾肿块的患者。
在研究期间,共有144例患者的171个肾肿块接受了腹腔镜冷冻消融治疗。排除随访时间<5年的患者以及临床分期>I期的患者后,92例患者治疗的112个肾肿块纳入分析。患者平均年龄为59.6岁(标准差[SD],12.5岁)。平均病变大小为2.3 cm(SD,0.94 cm)。平均年龄校正的查尔森合并症指数为4.55(SD,1.69)。平均随访时间为97.9个月(SD,24.8个月)。所有患者的总生存率为80.9%。70例患者(76.3%)的病变经活检证实为恶性。在活检证实为恶性的患者中,有6例复发,14例非癌症相关死亡,1例癌症相关死亡,导致总生存率为77.6%,无进展生存率为91.0%,癌症特异性生存率为98.5%。
我们报告了已发表的最大系列的腹腔镜肾冷冻消融病例,且随访时间最长。我们的系列研究表明,腹腔镜冷冻消融对于临床分期为T1期的肾肿块是一种有效的治疗方法,并能提供出色的长期肿瘤学结局。