Kim Hae Jin, Park Byung Kwan, Park Jung Jae, Kim Chan Kyo
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Korean J Radiol. 2016 Sep-Oct;17(5):763-70. doi: 10.3348/kjr.2016.17.5.763. Epub 2016 Aug 23.
To evaluate the mid-term outcomes of percutaneous radiofrequency ablation (RFA) treatment in patients with small (< 4 cm) renal cell carcinoma (RCC) in Korea.
Between 2010 and 2015, 51 patients (40 men and 11 women; median age, 57 years) with biopsyproven 51 RCC were treated using CT-guided RFA. All patients were clinically staged T1aN0M0 prior to RFA. The median tumor size and follow-up period were 2.1 cm (range, 1.0-3.9 cm) and 26 months (4-60 months), respectively. Local tumor progression, distant metastasis, primary and secondary effectiveness rates, and major complication rates were recorded. Estimated glomerular filtration rates (GFRs) between pre-RFA and last follow-up were compared using paired t tests. The 2-year recurrence-free survival rate was calculated using Kaplan-Meier survival analysis.
Of the 51 patients, 2 (3.9%) experienced local tumor progression, and 1 (2.0%) had lymph node metastasis after the first RFA session. Primary and secondary effectiveness rates were 96.1% (49/51) and 100% (1/1), respectively. Only 1 patient experienced a major complication (uretero-pelvic stricture) after the second RFA session for treating a local tumor progression, and the major complication rate was 1.9% (1/52). The median pre-RFA and last follow-up GFRs were 87.1 mL/ min/1.73 m(2) (14.2-142.7 mL/min/1.73 m(2)) and 72.0 mL/min/1.73 m(2) (7.2-112.6 mL/min/1.73 m(2)), respectively (p < 0.0001). The 2-year recurrence-free survival rate was 96.0%.
CT-guided RFA is a safe and effective treatment in Korean patients with T1a RCC because of excellent mid-term outcomes.
评估韩国小（<4cm）肾细胞癌（RCC）患者经皮射频消融（RFA）治疗的中期疗效。
2010年至2015年期间，对51例经活检证实为RCC的患者（40例男性和11例女性；中位年龄57岁）采用CT引导下的RFA进行治疗。所有患者在RFA术前临床分期均为T1aN0M0。肿瘤中位大小和随访期分别为2.1cm（范围1.0 - 3.9cm）和26个月（4 - 60个月）。记录局部肿瘤进展、远处转移、初次和二次有效率以及主要并发症发生率。使用配对t检验比较RFA术前和末次随访时的估计肾小球滤过率（GFR）。采用Kaplan - Meier生存分析计算2年无复发生存率。
51例患者中，2例（3.9%）在首次RFA治疗后出现局部肿瘤进展，1例（2.0%）出现淋巴结转移。初次和二次有效率分别为96.1%（49/51）和100%（1/1）。仅1例患者在第二次RFA治疗局部肿瘤进展后出现主要并发症（输尿管肾盂狭窄），主要并发症发生率为1.9%（1/52）。RFA术前和末次随访时GFR的中位数分别为87.1 mL/min/1.73m²（14.2 - 142.7 mL/min/1.73m²）和72.0 mL/min/1.73m²（7.2 - 112.6 mL/min/1.73m²）（p < 0.0001）。2年无复发生存率为96.0%。
由于中期疗效良好，CT引导下的RFA对韩国T1a期RCC患者是一种安全有效的治疗方法。
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